=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720122476
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANE ATKINS RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12 BALLARD ST
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03824-2308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-862-1530
-----------------------------------------------------
Fax | 603-862-4259
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 135 ATLANTIC AVE
-----------------------------------------------------
City | NORTH HAMPTON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03862-2310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-964-1954
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | R1357
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------