Provider Demographics
NPI:1588008155
Name:MANSEAU, JOLINE R (APRN)
Entity Type:Individual
Prefix:
First Name:JOLINE
Middle Name:R
Last Name:MANSEAU
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 1:399 DANIEL WEBSTER HWY
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4112
Mailing Address - Country:US
Mailing Address - Phone:603-429-1611
Mailing Address - Fax:603-429-1285
Practice Address - Street 1:399 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4112
Practice Address - Country:US
Practice Address - Phone:603-429-1611
Practice Address - Fax:603-429-1285
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02149323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily