Healthcare Provider Details

I. General information

NPI: 1902804057
Provider Name (Legal Business Name): NOVAMED SURGERY CENTER OF NASHUA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 COLISEUM AVE STE 7
NASHUA NH
03063-3206
US

IV. Provider business mailing address

5 COLISEUM AVE STE 7
NASHUA NH
03063-3206
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-9800
  • Fax: 603-882-0556
Mailing address:
  • Phone: 603-882-9800
  • Fax: 603-882-0556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNH

VIII. Authorized Official

Name: JENNIFER BOYD BALDOCK
Title or Position: OFFICER AND AUTHORIZED OFFICIAL
Credential:
Phone: 615-234-5954