Provider Demographics
NPI:1609817477
Name:GUTT, JOANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:GUTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PLEASANT STREET
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 1
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-227-7000
Mailing Address - Fax:603-228-7350
Practice Address - Street 1:246 PLEASANT STREET
Practice Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 1
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-227-7000
Practice Address - Fax:603-228-7350
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH0296P363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHS31427Medicare UPIN