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General NPI Number Information
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NPI Number | 1043390776
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Entity Type | Organization
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Legal Business Name | CAPITAL REGION HEALTH VENTURES CORPORATION
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 81 HALL ST SUITE 1
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City | CONCORD
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State | NH
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Zip | 03301-3488
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Country | US
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Telephone | 603-228-7600
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Fax | 603-228-7320
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Provider Business Mailing Address
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Address Line | 81 HALL ST SUITE 1
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City | CONCORD
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State | NH
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Zip | 03301-3488
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Country | US
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Telephone | 603-228-7600
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Fax | 603-228-7320
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | BRUCE BURNS
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Credential |
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Telephone | 603-225-2711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0172652301
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License Number State | NH
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