Healthcare Provider Details

I. General information

NPI: 1083075550
Provider Name (Legal Business Name): VICTORIA A FERRANTE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 COURT ST
KEENE NH
03431
US

IV. Provider business mailing address

590 COURT ST
KEENE NH
03431
US

V. Phone/Fax

Practice location:
  • Phone: 603-354-5400
  • Fax:
Mailing address:
  • Phone: 603-354-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number3271
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1085253
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1287
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: