MEDICARE: MRS. MARIAN J DESROCHERS APRN

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	363LF0000X	Family Nurse Practitioner	046248-23	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225008592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIAN J DESROCHERS APRN

Provider Business Mailing Address
First Line	:	13 HIGHFIELD DR
Second Line	:
City	:	ALLENSTOWN
State	:	NH
Zip	:	03275-2622
Country	:	US
Telephone Number	:	603-268-0332
Fax Number	:

Provider Business Practice Location Address
First Line	:	246 WALNUT ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02460-1639
Country	:	US
Telephone Number	:	617-244-3322
Fax Number	:	617-244-1827

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	02/11/2014

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