Provider Demographics
NPI:1841440807
Name:PEASE, ANNEMARIE (RD, LDN)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:PEASE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55A LUND DR
Mailing Address - Street 2:55A LUND DRIVE
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3924
Mailing Address - Country:US
Mailing Address - Phone:978-835-4496
Mailing Address - Fax:
Practice Address - Street 1:87 INDIAN ROCK RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1656
Practice Address - Country:US
Practice Address - Phone:978-225-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000002780133V00000X
NH0679133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered