Healthcare Provider Details

I. General information

NPI: 1710693080
Provider Name (Legal Business Name): ALYSHA CUTTS MSN PMHNP-BC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 GILCREAST RD
LONDONDERRY NH
03053-3564
US

IV. Provider business mailing address

75 GILCREAST RD
LONDONDERRY NH
03053-3564
US

V. Phone/Fax

Practice location:
  • Phone: 603-782-9691
  • Fax:
Mailing address:
  • Phone: 603-782-9691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALYSHA CUTTS
Title or Position: CEO
Credential:
Phone: 603-782-9691