MEDICARE: MRS. LILI CARGILL 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	363L00000X	Nurse Practitioner	04334923	NH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	04334923	NH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00220136	OTHER	NH	RAIL ROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417906496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILI CARGILL ARNP

Provider Business Mailing Address
First Line	:	3855 DARTMOUTH COLLEGE HWY
Second Line	:
City	:	NORTH HAVERHILL
State	:	NH
Zip	:	03774-4937
Country	:	US
Telephone Number	:	603-787-6971
Fax Number	:	603-787-2012

Provider Business Practice Location Address
First Line	:	3855 DARTMOUTH COLLEGE HWY
Second Line	:
City	:	NORTH HAVERHILL
State	:	NH
Zip	:	03774-4937
Country	:	US
Telephone Number	:	603-787-6971
Fax Number	:	603-787-2012

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	05/26/2021

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Directions to “ MRS. LILI CARGILL ARNP” Practice Location

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