Provider Demographics
NPI:1245255314
Name:STOCKER, JANET C (APRN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:C
Last Name:STOCKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-742-8787
Mailing Address - Fax:603-740-2446
Practice Address - Street 1:789 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2526
Practice Address - Country:US
Practice Address - Phone:603-742-8787
Practice Address - Fax:603-740-2446
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH032878-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076120Medicaid
ME1245255314Medicaid
NHNP540201Medicare PIN
NH3076120Medicaid