Healthcare Provider Details

I. General information

NPI: 1225432347
Provider Name (Legal Business Name): PATTY M DUMONT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ELLIOT WAY SUITE 200
MANCHESTER NH
03103-3547
US

IV. Provider business mailing address

4 ELLIOT WAY SUITE 200
MANCHESTER NH
03103-3547
US

V. Phone/Fax

Practice location:
  • Phone: 603-669-9200
  • Fax: 603-624-2210
Mailing address:
  • Phone: 603-669-9200
  • Fax: 603-624-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number053415-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: