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General NPI Number Information
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NPI Number | 1104276757
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Entity Type | Individual
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Provider Name | NICOLE CORRINE POITRAS MSN, APRN
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Gender | Female
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 89 S MAST ST #6
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City | GOFFSTOWN
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State | NH
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Zip | 03045-6102
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Country | US
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Telephone | 603-497-5661
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Fax |
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Provider Business Mailing Address
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Address Line | 47 LITCHFIELD RD
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City | LONDONDERRY
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State | NH
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Zip | 03053-2624
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Country | US
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Telephone | 603-845-7718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 046532-23
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License Number State | NH
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