Healthcare Provider Details

I. General information

NPI: 1700881026
Provider Name (Legal Business Name): CYMANDE A BAXTER-ROGERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S MAIN ST
WOLFEBORO NH
03894-4455
US

IV. Provider business mailing address

87 WASHINGTON ST
CONWAY NH
03818-6093
US

V. Phone/Fax

Practice location:
  • Phone: 603-596-7500
  • Fax:
Mailing address:
  • Phone: 603-447-3347
  • Fax: 603-444-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number074752-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: