Healthcare Provider Details

I. General information

NPI: 1851992960
Provider Name (Legal Business Name): TINA MCGUIRK APRN-FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
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: 603-577-1613
  • Fax: 603-809-4934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number066326-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: