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NPI Code Detail

MEDICARE: DONNA MOHAN ARNP

MEDICARE: DONNA MOHAN 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
1363L00000XNurse Practitioner039386-23-03NH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NP0841OTHERMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902902075
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA MOHAN ARNP
Provider Business Mailing Address
First Line : 480 MONT VERNON RD.
Second Line :
City : NEW BOSTON
State : NH
Zip : 03070
Country : US
Telephone Number : 603-897-5485
Fax Number :
Provider Business Practice Location Address
First Line : 170 COMMERCE WAY STE 103
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-3272
Country : US
Telephone Number : 603-897-5485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 01/05/2016

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