Provider Demographics
NPI:1336141225
Name:SHUTE, PATRICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SHUTE
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 1:133 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-2006
Mailing Address - Country:US
Mailing Address - Phone:603-752-2040
Mailing Address - Fax:603-752-7797
Practice Address - Street 1:133 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-2006
Practice Address - Country:US
Practice Address - Phone:603-752-2040
Practice Address - Fax:603-752-7797
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0388672301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2300984YPNH01OtherANTHEM BC/BS
NH30006937Medicaid
NH0388672301OtherSTATE LICENSE #
NH3071675Medicaid
NH1600919OtherCIGNA HEALTHCARE
5830418OtherAETNA GROUP
5830418OtherAETNA GROUP
NH0388672301OtherSTATE LICENSE #
RE3469Medicare ID - Type Unspecified