Provider Demographics
NPI:1033629068
Name:ROY, CAILLE S (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CAILLE
Middle Name:S
Last Name:ROY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1835
Mailing Address - Country:US
Mailing Address - Phone:603-659-3106
Mailing Address - Fax:
Practice Address - Street 1:207 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWMARKET
Practice Address - State:NH
Practice Address - Zip Code:03857
Practice Address - Country:US
Practice Address - Phone:603-659-3106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2018-09-28
Deactivation Date:2017-12-07
Deactivation Code:
Reactivation Date:2018-01-04
Provider Licenses
StateLicense IDTaxonomies
MARN2304011363LF0000X
NH072693-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily