Healthcare Provider Details
I. General information
NPI: 1477250801
Provider Name (Legal Business Name): DEBORAH E LARRIMORE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/15/2023
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
412 DODGE HOLLOW RD # 412
LEMPSTER NH
03605-3426
US
IV. Provider business mailing address
412 DODGE HOLLOW RD # 412
LEMPSTER NH
03605-3426
US
V. Phone/Fax
- Phone: 603-443-1967
- Fax:
- Phone: 603-443-1967
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | 082917-21 |
| License Number State | NH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP2201X |
| Taxonomy | Ambulatory Care Registered Nurse |
| License Number | 082917-21 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: