MEDICARE: MRS. LINDA M DOUVILLE ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	024537-23-05	NH

General Provider Information

NPI Number	:	1043271257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA M DOUVILLE ARNP

Provider Business Mailing Address
First Line	:	123 TOWN FARM RD
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-4225
Country	:	US
Telephone Number	:	603-887-2068
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 TOWN FARM RD
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-4225
Country	:	US
Telephone Number	:	603-887-2068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2007

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