Healthcare Provider Details
I. General information
NPI: 1679024624
Provider Name (Legal Business Name): MELISSA FRENCH APRN PMHNP BC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
61 ROUTE 27 STE 10
RAYMOND NH
03077-1273
US
IV. Provider business mailing address
26 LYNDEBOROUGH RD
AMHERST NH
03031-3046
US
V. Phone/Fax
- Phone: 603-988-3126
- Fax:
- Phone: 603-988-3126
- Fax: 603-249-5129
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 06447623 |
| License Number State | NH |
VIII. Authorized Official
Name:
MELISSA
M
FRENCH
Title or Position: OWNER
Credential: APRN
Phone: 603-988-3126