Healthcare Provider Details

I. General information

NPI: 1043673379
Provider Name (Legal Business Name): NONG CHRANG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 WORKS WAY
SOMERSWORTH NH
03878-1639
US

IV. Provider business mailing address

7 WORKS WAY
SOMERSWORTH NH
03878-1639
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-4018
  • Fax: 833-944-2270
Mailing address:
  • Phone: 603-692-4018
  • Fax: 833-944-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP161014
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number051422-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: