Individual
MRS. MARY MARGARITA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
48 GLASS ST, PEMBROKE, NH 03275-1506
(603) 485-7788
(603) 485-7799
Mailing address
62 ISLAND DR, MERRIMACK, NH 03054-4123
(603) 206-4390
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
038972-23-03
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30341583
—
NH
Enumeration date
12/08/2006
Last updated
10/30/2007
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