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General NPI Number Information
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NPI Number | 1225380942
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Entity Type | Individual
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Provider Name | YELENA NICOLAEVNA COURCHENE PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 3 MOUND CT
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City | MERRIMACK
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State | NH
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Zip | 03054-4412
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Country | US
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Telephone | 603-424-8866
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Fax | 833-944-2252
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Provider Business Mailing Address
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Address Line | 3 MOUND CT
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City | MERRIMACK
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State | NH
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Zip | 03054-4412
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Country | US
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Telephone | 603-424-8866
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Fax | 833-944-2252
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0916
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License Number State | NH
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