Healthcare Provider Details

I. General information

NPI: 1760282123
Provider Name (Legal Business Name): MELINDA CELINA TAYLOR-BOSWORTH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BEACON ST E
LACONIA NH
03246-3437
US

IV. Provider business mailing address

40 BEACON ST E
LACONIA NH
03246-3437
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-1100
  • Fax:
Mailing address:
  • Phone: 603-455-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number078864-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number078864-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: