Doctor Name: | MRS. DIANE KATHRYN DESMARAIS |
NPI Number: | 1528475167 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 049432-23 |
Business Practice Address: | 14 Maple St Gilford, NH - 032496580 |
Business Phone Number: | 6036640100 |
Business Fax Number: | |
Mailing Address: | 80 Ginger Dr, GOFFSTOWN |
State: | NH |
Postal Code: | 030452939 |
Phone Number: | 6036640100 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2014 |
NPI Last Update Date: | 07/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 049432-23 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |