Healthcare Provider Details

I. General information

NPI: 1790446664
Provider Name (Legal Business Name): JULIE KAYE LIMMER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BROADWAY AVE
GORHAM NH
03581-1597
US

IV. Provider business mailing address

#5 ROCKY HOLLOW LANE, PO BOX 515
GLEN NH
03838-0515
US

V. Phone/Fax

Practice location:
  • Phone: 603-466-2741
  • Fax: 603-466-2953
Mailing address:
  • Phone: 603-986-9484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number066010-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: