Provider Demographics
NPI:1609965995
Name:LAMSTEIN, MARY C (APRN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:LAMSTEIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:C
Other - Last Name:LAMSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PP
Mailing Address - Street 1:100 SHATTUCK WAY SUITE 100
Mailing Address - Street 2:WHOLE LIFE HEALTH CARE
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:603-431-6677
Mailing Address - Fax:603-610-2232
Practice Address - Street 1:100 SHATTUCK WAY SUITE 100
Practice Address - Street 2:WHOLE LIFE HEALTH CARE
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-431-6677
Practice Address - Fax:603-610-2232
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081085363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME273460099Medicaid
S94892Medicare UPIN
ME273460099Medicaid