Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0320352305 | NH |
NPI | 1427151638 |
---|---|
Provider Name | Ms. Mary Margaret Sanford |
First Address | Pelham, NH 03076-3004 |
Second Address | Manchester, NH 03102-3730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |