Healthcare Provider Details

I. General information

NPI: 1043400732
Provider Name (Legal Business Name): JUDY LINDA GARIEPY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2007
Last Update Date: 07/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 SMYTH RD
MANCHESTER NH
03104-7007
US

IV. Provider business mailing address

366 OLD COUNTY RD
HAMPDEN ME
04444-1912
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-4366
  • Fax:
Mailing address:
  • Phone: 207-852-3776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberR038727
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: