=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497557979
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARI GUSTAD APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2025
-----------------------------------------------------
Last Update Date | 08/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 273 COUNTY RD
-----------------------------------------------------
City | NEW LONDON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03257-5736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-526-5155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 810
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03755-0810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 071764-23
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 071764-23
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------