Healthcare Provider Details

I. General information

NPI: 1215389366
Provider Name (Legal Business Name): WILLIAM MITCHELL LEWITT NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 KINSLEY ST STE 101
NASHUA NH
03060-3676
US

IV. Provider business mailing address

25 FORRENCE DRIVE
HOLLIS NH
03049
US

V. Phone/Fax

Practice location:
  • Phone: 603-889-4131
  • Fax: 603-889-6419
Mailing address:
  • Phone: 617-304-0648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number073326-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: