Provider Demographics
NPI:1134260607
Name:ROMBOLI, JOAN ELLEN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ELLEN
Last Name:ROMBOLI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 ROBERT HALL RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-7737
Mailing Address - Country:US
Mailing Address - Phone:603-235-1934
Mailing Address - Fax:
Practice Address - Street 1:1 COMMONS DR
Practice Address - Street 2:STE 24
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3467
Practice Address - Country:US
Practice Address - Phone:603-425-6494
Practice Address - Fax:603-425-2048
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH031738-23-03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH539030OtherCIGNA
NH30341803Medicaid
NH713165OtherHARVARD PILGRIM
NH8300027OtherUNITED HEALTHCARE
NHNP1567Medicare ID - Type Unspecified
NH713165OtherHARVARD PILGRIM