Healthcare Provider Details

I. General information

NPI: 1750273348
Provider Name (Legal Business Name): MRS. EMILY NICOLE HYDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 LEXINGTON DR
LACONIA NH
03246-3945
US

IV. Provider business mailing address

66 PROVINCE ST APT 2
LACONIA NH
03246-3837
US

V. Phone/Fax

Practice location:
  • Phone: 603-527-8021
  • Fax:
Mailing address:
  • Phone: 540-686-2153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: