Provider Demographics
NPI:1124002415
Name:WARREN, MARY H (APRN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:H
Last Name:WARREN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PINE STREET EXT
Mailing Address - Street 2:#6 MILL ANNEX SUITE K
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3213
Mailing Address - Country:US
Mailing Address - Phone:603-886-4800
Mailing Address - Fax:603-886-4810
Practice Address - Street 1:5 PINE STREET EXT
Practice Address - Street 2:#6 MILL ANNEX SUITE K
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3213
Practice Address - Country:US
Practice Address - Phone:603-886-4800
Practice Address - Fax:603-886-4810
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH027571-23-08363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH363LP0808ZOtherARNP- MENTAL HEALTH
NH363LP0808ZOtherARNP- MENTAL HEALTH