Smith, Justin

Smith, Justin is an individual health care provider with primary practice located at 4 Elliot Way Ste 200 , Manchester NH 03103-3544. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Smith, Justin can be contacted via phone (603) 669-9200.

Contact Information

Primary practice address
4 Elliot Way Ste 200 Manchester NH 03103-3544
Fax: (260) 230-2053
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 073522-23 New Hampshire

Profile Details

NPI number 1275041642
LBN Legal business name Smith, Justin
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2018
Last updated Apr 20th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275041642 NPPES
New Hampshire MEDICAID 3111508

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