Doctor Name: | LAURIE BROCKELMAN |
NPI Number: | 1437513140 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 062618-23 |
Business Practice Address: | 462 Route 119 East Fitzwilliam, NH - 034473149 |
Business Phone Number: | 6035856788 |
Business Fax Number: | |
Mailing Address: | 462 Rte 119 East, FITZ;WILLIAM |
State: | NH |
Postal Code: | 034473149 |
Phone Number: | 6035856788 |
Fax Number: | |
NPI Enumeration Date: | 04/08/2016 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 062618-23 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |