Healthcare Provider Details

I. General information

NPI: 1275911729
Provider Name (Legal Business Name): BARBARA A LANE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 TABOR RD
HAMPSTEAD NH
03841-5153
US

IV. Provider business mailing address

16 TABOR RD
HAMPSTEAD NH
03841-5153
US

V. Phone/Fax

Practice location:
  • Phone: 603-489-7153
  • Fax:
Mailing address:
  • Phone: 603-489-7153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number10218
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number026007-21
License Number StateNH

VIII. Authorized Official

Name: BARBARA LANE
Title or Position: HOME CARE NURSE
Credential: RN
Phone: 603-489-7153