1659984581 NPI number — MRS. EMILY ELIZABETH GAUVIN FNP

Table of content: MRS. EMILY ELIZABETH GAUVIN FNP (NPI 1659984581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659984581 NPI number — MRS. EMILY ELIZABETH GAUVIN FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAUVIN
Provider First Name:
EMILY
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VECCHIONE
Provider Other First Name:
EMILY
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659984581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 STILES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03079-2846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
774-766-7651
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 STILES RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03079-2846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-386-0100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  079041-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN2301597 . This is a "MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 079041-23 . This is a "NH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".