Provider Demographics
NPI:1922011485
Name:ARCHAMBAULT, JANET LYNN (MSN, ARNP, BSN)
Entity Type:Individual
Prefix:MISS
First Name:JANET
Middle Name:LYNN
Last Name:ARCHAMBAULT
Suffix:
Gender:F
Credentials:MSN, ARNP, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CRICKET LN
Mailing Address - Street 2:
Mailing Address - City:ROLLINSFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03869-5600
Mailing Address - Country:US
Mailing Address - Phone:603-742-7773
Mailing Address - Fax:603-742-7773
Practice Address - Street 1:118 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3787
Practice Address - Country:US
Practice Address - Phone:603-219-6679
Practice Address - Fax:603-436-1860
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH022549-23-08363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343710Medicaid