Healthcare Provider Details

I. General information

NPI: 1578657052
Provider Name (Legal Business Name): ANNE M JOHNSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ALLEN ST STE 100
HANOVER NH
03755-2065
US

IV. Provider business mailing address

7 ALLEN ST STE 100
HANOVER NH
03755-2065
US

V. Phone/Fax

Practice location:
  • Phone: 603-738-1164
  • Fax:
Mailing address:
  • Phone: 603-738-1164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD20335
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19811
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: