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General NPI Number Information
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NPI Number | 1902622103
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Entity Type | Organization
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Legal Business Name | NEXTGEN DIABETES CARE LLC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 510 OLD CANDIA RD
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City | CANDIA
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State | NH
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Zip | 03034-2400
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Country | US
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Telephone | 603-691-3771
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Fax | 833-438-1685
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Provider Business Mailing Address
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Address Line | 510 OLD CANDIA RD
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City | CANDIA
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State | NH
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Zip | 03034-2400
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Country | US
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Telephone | 603-691-3771
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Fax | 833-438-1685
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | BRETT ROBERTS
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Credential | APRN
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Telephone | 603-991-8917
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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 |
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License Number State |
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