Provider Demographics
NPI:1720231616
Name:STANHOPE, ROBERTA (ARNP,PMH, CNS, BC)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:STANHOPE
Suffix:
Gender:F
Credentials:ARNP,PMH, CNS, BC
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:
Other - Last Name:STANHOPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP,PMH,CNS,BC
Mailing Address - Street 1:13 JENKINS CT STE 220
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-2324
Mailing Address - Country:US
Mailing Address - Phone:603-651-0293
Mailing Address - Fax:603-815-4944
Practice Address - Street 1:13 JENKINS CT
Practice Address - Street 2:SUITE 220
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-2340
Practice Address - Country:US
Practice Address - Phone:603-651-0293
Practice Address - Fax:603-815-4944
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH054414-21163WP0809X
NH054414-23364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH12012954OtherCAQH