| NPI | 1609347087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIANNE L INGERSOLL Psychiatric Nurse Practitioner 603-490-7086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2019-07-23 |