Healthcare Provider Details

I. General information

NPI: 1801147095
Provider Name (Legal Business Name): SHARON OSTOW ROUSMANIERE CHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 WASHINGTON ST
KEENE NH
03431-3131
US

IV. Provider business mailing address

180 MIDDLETOWN RD
ROXBURY NH
03431-8704
US

V. Phone/Fax

Practice location:
  • Phone: 603-357-8928
  • Fax: 775-898-8838
Mailing address:
  • Phone: 603-357-8928
  • Fax: 775-898-8838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: