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General NPI Number Information
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NPI Number | 1346558491
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Entity Type | Individual
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Provider Name | DOROTHY HAVERTY-BUSSIERE NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 411 MERRIMACK ST 104
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City | METHUEN
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State | MA
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Zip | 01844-5821
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Country | US
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Telephone | 978-685-5627
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Fax |
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Provider Business Mailing Address
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Address Line | 21 MAIN ST
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City | PELHAM
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State | NH
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Zip | 03076-3722
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Country | US
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Telephone | 603-635-8402
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN217422
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License Number State | MA
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