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General NPI Number Information
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NPI Number | 1497630446
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Entity Type | Organization
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Legal Business Name | GRANITE PRIDE NEW HAMPSHIRE, PLLC
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 5 WARREN ST STE 3
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City | CONCORD
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State | NH
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Zip | 03301-4030
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Country | US
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Telephone | 603-227-6047
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Fax |
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Provider Business Mailing Address
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Address Line | 5 WARREN ST STE 3
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City | CONCORD
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State | NH
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Zip | 03301-4030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | APRN, FNP-C/ OWNER
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Name | JESSICA SMITH
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Credential | APRN
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Telephone | 603-227-6047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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