Healthcare Provider Details

I. General information

NPI: 1255579439
Provider Name (Legal Business Name): JILL NICOLE RUGGIERO ARNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WALL ST SUITE 300
MANCHESTER NH
03101-1518
US

IV. Provider business mailing address

2 WALL ST STE 300
MANCHESTER NH
03101-1518
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-4111
  • Fax: 603-641-6910
Mailing address:
  • Phone: 603-668-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number060485-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: