Provider Demographics
NPI:1750050530
Name:DAIGNEAULT FAMILY CARE PLLC
Entity Type:Organization
Organization Name:DAIGNEAULT FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAIGNEAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-580-1749
Mailing Address - Street 1:1 HAMPTON RD UNIT 107A
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4849
Mailing Address - Country:US
Mailing Address - Phone:603-580-1749
Mailing Address - Fax:
Practice Address - Street 1:1 HAMPTON RD UNIT 107A
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4849
Practice Address - Country:US
Practice Address - Phone:603-580-1749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty