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General NPI Number Information
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NPI Number | 1629517412
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Entity Type | Individual
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Provider Name | JESSICA LACHANCE NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 34 ROBERTSON DR
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City | GILFORD
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State | NH
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Zip | 03249
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Country | US
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Telephone | 603-524-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 211 HIGHLAND ST
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City | LACONIA
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State | NH
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Zip | 03246-3222
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Country | US
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Telephone | 603-387-8765
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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 | 058360-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 058360-21
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License Number State | NH
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