Healthcare Provider Details

I. General information

NPI: 1497469746
Provider Name (Legal Business Name): BRIDGET COLLEEN PAGANINI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. BRIDGET COLLEEN GRIFFIN

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 INDIAN ROCK RD
WINDHAM NH
03087-2008
US

IV. Provider business mailing address

360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH NH
03801-7105
US

V. Phone/Fax

Practice location:
  • Phone: 603-890-6330
  • Fax: 603-458-7626
Mailing address:
  • Phone: 603-410-6700
  • Fax: 603-319-8308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number071813-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number071813-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: