Provider Demographics
NPI:1609596659
Name:FISHWICK, REANNA CIRNIGLIARO (MS, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:REANNA
Middle Name:CIRNIGLIARO
Last Name:FISHWICK
Suffix:
Gender:F
Credentials:MS, APRN, FNP-BC
Other - Prefix:
Other - First Name:REANNA
Other - Middle Name:MARIE
Other - Last Name:CIRNIGLIARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:145 HOLLIS ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1235
Mailing Address - Country:US
Mailing Address - Phone:603-626-9500
Mailing Address - Fax:
Practice Address - Street 1:100 HITCHCOCK WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4125
Practice Address - Country:US
Practice Address - Phone:603-695-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH082985-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily