Healthcare Provider Details

I. General information

NPI: 1750405742
Provider Name (Legal Business Name): CAROL ANNE RENOUF ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 RANGE RD
WINDHAM NH
03087-2098
US

IV. Provider business mailing address

286 CENTRAL ST
EAST HAMPSTEAD NH
03826-2440
US

V. Phone/Fax

Practice location:
  • Phone: 603-893-4119
  • Fax:
Mailing address:
  • Phone: 603-382-9394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number016873-23-03
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: