Healthcare Provider Details

I. General information

NPI: 1407160989
Provider Name (Legal Business Name): JANICE LECOMPTE STILES RN PMHCNS-BC MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 TASKER HILL RD
STRAFFORD NH
03884-6857
US

IV. Provider business mailing address

96 TASKER HILL RD
STRAFFORD NH
03884-6857
US

V. Phone/Fax

Practice location:
  • Phone: 603-644-8288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number030636-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: