Provider Demographics
NPI:1467442129
Name:SHAPIRO, JUDITH DEBRA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:DEBRA
Last Name:SHAPIRO
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 1:1465 HOOKSETT RD
Mailing Address - Street 2:#310
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1860
Mailing Address - Country:US
Mailing Address - Phone:603-622-5754
Mailing Address - Fax:
Practice Address - Street 1:1244 HOOKSETT RD
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1024
Practice Address - Country:US
Practice Address - Phone:603-622-5754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0101422308363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30011034Medicaid
424844OtherHARVARD PILGRIM
009925OtherPACIFICARE
112369OtherTEAMSTERS
NYR0114OtherEMPIRE BLUE CROSS
40764OtherCIGNA
87726OtherUNITED BEHAVORIAL HEALTH
SHNP1133Medicare ID - Type Unspecified