Provider Demographics
NPI:1518002112
Name:DELUCA, ANNE M (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:M
Last Name:DELUCA
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 1:11 KIMBALL DR
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2603
Mailing Address - Country:US
Mailing Address - Phone:603-663-1990
Mailing Address - Fax:603-663-1989
Practice Address - Street 1:11 KIMBALL DR
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2603
Practice Address - Country:US
Practice Address - Phone:603-663-1990
Practice Address - Fax:603-663-1989
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH036744-23-05363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health