Healthcare Provider Details

I. General information

NPI: 1588713226
Provider Name (Legal Business Name): ANGELA MOYNIHAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 N BROADWAY
SALEM NH
03079-2132
US

IV. Provider business mailing address

44 OVERTON RD
WINDHAM NH
03087-1265
US

V. Phone/Fax

Practice location:
  • Phone: 603-893-8899
  • Fax: 603-893-3528
Mailing address:
  • Phone: 603-898-4824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number052977-23-03
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: