Healthcare Provider Details

I. General information

NPI: 1528169984
Provider Name (Legal Business Name): ANITA MARIE ONOFRIO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/03/2023
Certification Date: 02/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HANOVER ST
LEBANON NH
03766-1357
US

IV. Provider business mailing address

148 VAN DYKE RD
STRAFFORD VT
05072-9785
US

V. Phone/Fax

Practice location:
  • Phone: 603-413-0394
  • Fax: 603-413-0394
Mailing address:
  • Phone: 802-765-4507
  • Fax: 802-763-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number025013-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1010014619
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number025013-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: