Healthcare Provider Details

I. General information

NPI: 1184394827
Provider Name (Legal Business Name): KRISTIN DUCHARME APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN ALLEN

II. Dates (important events)

Enumeration Date: 09/15/2021
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DOBSON WAY
MERRIMACK NH
03054-4340
US

IV. Provider business mailing address

28 NATHAN LORD RD
AMHERST NH
03031-3004
US

V. Phone/Fax

Practice location:
  • Phone: 603-471-6069
  • Fax:
Mailing address:
  • Phone: 603-493-5877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0011908
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number055003-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: