Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3563 | NH |
NPI | 1003224031 |
---|---|
Provider Name | Nicole P Fitzpatrick |
First Address | Franconia, NH 03580-4401 |
Second Address | Franconia, NH 03580-4401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2014 |
Last Update Date | 09/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08Y025488NH01 | ANTHEM (01) | NH |
AAA388505 | HARVARD PILGRIM HEALTHCARE (01) | NH |