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General NPI Number Information
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NPI Number | 1861878571
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Entity Type | Individual
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Provider Name | SUSAN F MIRABELLO APRN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 100 MCGREGOR ST
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City | MANCHESTER
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State | NH
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Zip | 03102-3730
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Country | US
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Telephone | 603-663-6478
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Fax | 603-663-8015
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Provider Business Mailing Address
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Address Line | 875 ELM ST APT 507
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City | MANCHESTER
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State | NH
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Zip | 03101-2124
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Country | US
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Telephone | 603-663-6478
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Fax | 603-663-8015
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 056350-23
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License Number State | NH
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