Provider Demographics
NPI:1740733203
Name:GOGUEN, ALI (APRN)
Entity type:Individual
Prefix:MRS
First Name:ALI
Middle Name:
Last Name:GOGUEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:PELUNIS-MESSIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 ALLIANCE WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-8400
Mailing Address - Country:US
Mailing Address - Phone:603-836-2253
Mailing Address - Fax:
Practice Address - Street 1:200 ALLIANCE WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-8400
Practice Address - Country:US
Practice Address - Phone:603-836-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH065051-23363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily