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General NPI Number Information
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NPI Number | 1457861502
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Entity Type | Individual
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Provider Name | SANDRA ELIZABETH DWAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 100 HITCHCOCK WAY
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City | MANCHESTER
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State | NH
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Zip | 03104-4125
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Country | US
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Telephone | 603-695-2500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 810
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City | HANOVER
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State | NH
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Zip | 03755-0810
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Country | US
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Telephone | 603-308-1467
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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 | 066061-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2272871
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License Number State | MA
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