Provider Demographics
NPI:1659984581
Name:GAUVIN, EMILY ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:GAUVIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:VECCHIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2846
Mailing Address - Country:US
Mailing Address - Phone:774-766-7651
Mailing Address - Fax:
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2846
Practice Address - Country:US
Practice Address - Phone:603-386-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-29
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH079041-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2301597OtherMA
NH079041-23OtherNH