Healthcare Provider Details

I. General information

NPI: 1457933913
Provider Name (Legal Business Name): BRIE HUSSEY IHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2021
Last Update Date: 04/24/2021
Certification Date: 04/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WHITE PLAINS AVE
LONDONDERRY NH
03053-4608
US

IV. Provider business mailing address

4 WHITE PLAINS AVE
LONDONDERRY NH
03053-4608
US

V. Phone/Fax

Practice location:
  • Phone: 603-325-2428
  • Fax:
Mailing address:
  • Phone: 603-325-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: