Healthcare Provider Details

I. General information

NPI: 1497781173
Provider Name (Legal Business Name): BARBARA NADEAU PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 ROUTE 108
SOMERSWORTH NH
03878-1543
US

IV. Provider business mailing address

255 ROUTE 108
SOMERSWORTH NH
03878-1543
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-4018
  • Fax: 603-692-1083
Mailing address:
  • Phone: 603-692-4018
  • Fax: 603-692-1083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0285 P
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0285 P
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: