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General NPI Number Information
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NPI Number | 1932193828
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Entity Type | Individual
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Provider Name | STACEY L RHYNE APRN
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Gender | Female
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 789 CENTRAL AVE # LEVEL1
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City | DOVER
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State | NH
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Zip | 03820-2526
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Country | US
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Telephone | 603-610-8094
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Fax |
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Provider Business Mailing Address
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Address Line | 789 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-2526
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Country | US
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Telephone | 603-692-6676
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Fax | 603-692-0919
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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 | 037187-23
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License Number State | NH
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