Provider Demographics
NPI:1578828133
Name:ST. ONGE, CAROLE A (APRN)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:A
Last Name:ST. ONGE
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 1:253 PLEASANT ST
Mailing Address - Street 2:PRIMARY CARE
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7560
Mailing Address - Country:US
Mailing Address - Phone:603-226-6108
Mailing Address - Fax:603-229-5112
Practice Address - Street 1:253 PLEASANT ST
Practice Address - Street 2:PRIMARY CARE
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7560
Practice Address - Country:US
Practice Address - Phone:603-226-6108
Practice Address - Fax:603-229-5112
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH027532-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily