Healthcare Provider Details

I. General information

NPI: 1407503840
Provider Name (Legal Business Name): ALLYSON JUNE JANOSZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2022
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 AMHERST ST
NASHUA NH
03063-1255
US

IV. Provider business mailing address

PO BOX 95000 LBX 7655
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 603-883-7970
  • Fax: 603-595-3652
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number085686-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number085686-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: