Healthcare Provider Details

I. General information

NPI: 1740855576
Provider Name (Legal Business Name): CRISTA PEHL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRISTA HARB

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 W HOLLIS ST STE 106
NASHUA NH
03062-1386
US

IV. Provider business mailing address

505 W HOLLIS ST STE 106
NASHUA NH
03062-1386
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-1613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0181282-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2308872
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: