Provider Demographics
NPI:1649763103
Name:COMPASS FAMILY HEALTH LLC
Entity Type:Organization
Organization Name:COMPASS FAMILY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, APRN, DNP
Authorized Official - Phone:603-749-0001
Mailing Address - Street 1:835 CENTRAL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2506
Mailing Address - Country:US
Mailing Address - Phone:603-749-0001
Mailing Address - Fax:603-749-1006
Practice Address - Street 1:835 CENTRAL AVE STE 200
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2506
Practice Address - Country:US
Practice Address - Phone:603-749-0001
Practice Address - Fax:603-749-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-10
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH074094-23207Q00000X
363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH059335-23OtherNH STATE NURSING BOARD