Healthcare Provider Details

I. General information

NPI: 1780283432
Provider Name (Legal Business Name): MALINDA HELEN MCEVOY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GREEN MOUNTAIN TREATMENT CENTER 244 HIGHWATCH RD
EFFINGHAM NH
03882
US

IV. Provider business mailing address

244 HIGH WATCH RD
EFFINGHAM NH
03882-8336
US

V. Phone/Fax

Practice location:
  • Phone: 866-652-8889
  • Fax:
Mailing address:
  • Phone: 603-539-8780
  • Fax: 603-539-8732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201233
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number083784-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: