Healthcare Provider Details

I. General information

NPI: 1326423716
Provider Name (Legal Business Name): WARREN JASON GABAREE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAKE AVE
MANCHESTER NH
03103-2734
US

IV. Provider business mailing address

116 SPRUCE POND RD
STRAFFORD NH
03884-6630
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-3020
  • Fax:
Mailing address:
  • Phone: 603-502-4348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number065142-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: