Provider Demographics
NPI:1205933983
Name:PIPER, COREY A (APRN)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:A
Last Name:PIPER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:SANDOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03873-2450
Mailing Address - Country:US
Mailing Address - Phone:603-978-5999
Mailing Address - Fax:603-887-2044
Practice Address - Street 1:COLONIAL POPLIN NURSING HOME
Practice Address - Street 2:442 MAIN ST
Practice Address - City:FREMONT
Practice Address - State:NH
Practice Address - Zip Code:03044-3434
Practice Address - Country:US
Practice Address - Phone:603-895-3126
Practice Address - Fax:603-895-3662
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH036290-23363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30340087Medicaid
S58449Medicare UPIN
NH30340087Medicaid