Provider Demographics
NPI:1821084823
Name:DIRUBBO, NANCY ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:DIRUBBO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2817
Mailing Address - Country:US
Mailing Address - Phone:603-528-4304
Mailing Address - Fax:603-528-8077
Practice Address - Street 1:501 UNION AVE
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2817
Practice Address - Country:US
Practice Address - Phone:603-528-4304
Practice Address - Fax:603-528-8077
Is Sole Proprietor?:No
Enumeration Date:2005-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0221892303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80938836Medicaid
NHR74575Medicare UPIN
NH80938836Medicaid