Provider Demographics
NPI:1417906496
Name:CARGILL, LILI (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LILI
Middle Name:
Last Name:CARGILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 DARTMOUTH COLLEGE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVERHILL
Mailing Address - State:NH
Mailing Address - Zip Code:03774-4937
Mailing Address - Country:US
Mailing Address - Phone:603-787-6971
Mailing Address - Fax:603-787-2012
Practice Address - Street 1:3855 DARTMOUTH COLLEGE HWY
Practice Address - Street 2:
Practice Address - City:NORTH HAVERHILL
Practice Address - State:NH
Practice Address - Zip Code:03774-4937
Practice Address - Country:US
Practice Address - Phone:603-787-6971
Practice Address - Fax:603-787-2012
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04334923363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343565Medicaid
VT1011531Medicaid
NHP00220136OtherRAIL ROAD MEDICARE
NHNP5022Medicare PIN
NHP00220136OtherRAIL ROAD MEDICARE