Provider Demographics
NPI:1730675562
Name:BOUTSELIS, HANNAH E (APRN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:E
Last Name:BOUTSELIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:ELIZABETH
Other - Last Name:DUBOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1750 ELM ST.
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104
Mailing Address - Country:US
Mailing Address - Phone:603-623-3343
Mailing Address - Fax:603-623-7924
Practice Address - Street 1:1750 ELM ST.
Practice Address - Street 2:SUITE 201A
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-623-3343
Practice Address - Fax:603-623-7924
Is Sole Proprietor?:No
Enumeration Date:2018-07-04
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH066272-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily