Healthcare Provider Details

I. General information

NPI: 1881827608
Provider Name (Legal Business Name): ELIZABETH KIRBY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH SPORIE

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 EXETER RD UNIT 3
NEWMARKET NH
03857-1940
US

IV. Provider business mailing address

789 CENTRAL AVE
DOVER NH
03820-2526
US

V. Phone/Fax

Practice location:
  • Phone: 603-659-0901
  • Fax:
Mailing address:
  • Phone: 603-659-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number050777-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: