Provider Demographics
NPI:1962684290
Name:CITRON, DORIS BLACKMAN (EDD, ARNP, CS)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:BLACKMAN
Last Name:CITRON
Suffix:
Gender:F
Credentials:EDD, ARNP, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7018
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-7018
Mailing Address - Country:US
Mailing Address - Phone:603-528-5011
Mailing Address - Fax:603-253-8078
Practice Address - Street 1:36 COUNTRY CLUB RD
Practice Address - Street 2:SUITE 823
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6978
Practice Address - Country:US
Practice Address - Phone:603-528-5011
Practice Address - Fax:603-253-8078
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH014437-21163W00000X
NH014437-23-08363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse