Provider Demographics
NPI:1093747255
Name:ALIE, BRITYN (CNM)
Entity Type:Individual
Prefix:
First Name:BRITYN
Middle Name:
Last Name:ALIE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7560
Mailing Address - Country:US
Mailing Address - Phone:603-653-9500
Mailing Address - Fax:
Practice Address - Street 1:253 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7560
Practice Address - Country:US
Practice Address - Phone:603-653-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH050238-23367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH40Y004628NH01OtherANTHEM
NH30342501Medicaid
NH40Y004628NH01OtherANTHEM
P85877Medicare UPIN