Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0359282302 | NH |
NPI | 1003875162 |
---|---|
Provider Name | Janice J Michaud |
First Address | Exeter, NH 03833-2997 |
Second Address | Stratham, NH 03885 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2006 |
Last Update Date | 16/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3076917 | (05) | NH |