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General NPI Number Information
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NPI Number | 1225959398
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Entity Type | Individual
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Provider Name | GABRIELLE PETERSON
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Gender | Female
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 1070 HOLT AVE
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City | MANCHESTER
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State | NH
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Zip | 03109-5603
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Country | US
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Telephone | 603-663-4857
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Fax |
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Provider Business Mailing Address
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Address Line | 980 MAIN ST UNIT 3
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City | FREMONT
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State | NH
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Zip | 03044-3597
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Country | US
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Telephone | 413-530-9290
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 088406-21
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License Number State | NH
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