Healthcare Provider Details

I. General information

NPI: 1427074178
Provider Name (Legal Business Name): DEBRA ANN FOURNIER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR DHMC / PHYSICAL MEDICINE
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-6330
  • Fax: 603-640-1228
Mailing address:
  • Phone: 603-650-6330
  • Fax: 603-650-6390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number050234-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number050234-23
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0523421
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: