Provider Demographics
NPI:1770928582
Name:PHANEUF, CHARLOTTE ELIZABETH (MSN, APRN, NP-C)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:ELIZABETH
Last Name:PHANEUF
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 SHERBURNE HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03261-3329
Mailing Address - Country:US
Mailing Address - Phone:603-608-6614
Mailing Address - Fax:
Practice Address - Street 1:60 COMMERCIAL ST STE 303
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5096
Practice Address - Country:US
Practice Address - Phone:603-608-6614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043825-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily