Provider Demographics
NPI:1932416302
Name:WESTON, EMILY (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:DAIGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:10 MEMBERS WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-5933
Mailing Address - Country:US
Mailing Address - Phone:603-740-2307
Mailing Address - Fax:603-609-6924
Practice Address - Street 1:789 CENTRAL AVE
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:603-740-2307
Practice Address - Fax:603-609-6924
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH054355-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3074047Medicaid
ME1932416302Medicaid
NH3074047Medicaid