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Individual

MRS. CORNELIA H. GONSALVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN,CPNP,APRN

Contact information

Practice address
275 MAMMOTH RD STE 2, MANCHESTER, NH 03109-4133
(603) 325-1273
Mailing address
275 MAMMOTH RD STE 2, MANCHESTER, NH 03109-4133
(603) 325-1273

Taxonomy

Speciality
Code
Description
License number
State
2080C0008X
Child Abuse Pediatrics Physician
074682-23
NH
363LP0200X
Pediatric Nurse Practitioner
Primary
074682-23
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3106451
NH
Enumeration date
10/16/2006
Last updated
10/02/2023
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