Healthcare Provider Details

I. General information

NPI: 1750610598
Provider Name (Legal Business Name): CHERYL DOUCETTE ANP BC PMHCNS BC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2009
Last Update Date: 09/02/2025
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 MOUNTAIN PARK DRIVE
WOODSTOCK NH
03262-0005
US

IV. Provider business mailing address

PO BOX 5
NORTH WOODSTOCK NH
03262-0005
US

V. Phone/Fax

Practice location:
  • Phone: 603-728-8872
  • Fax: 603-745-7089
Mailing address:
  • Phone: 603-728-8872
  • Fax: 603-945-8991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: CHERYL ANN DOUCETTE
Title or Position: OWNER, MANAGER
Credential:
Phone: 603-728-8872