Individual
MR. JUSTIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
4 ELLIOT WAY STE 200, MANCHESTER, NH 03103-3544
(603) 669-9200
(260) 230-2053
Mailing address
4 ELLIOT WAY STE 200, MANCHESTER, NH 03103-3544
(603) 669-9200
(260) 230-2053
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
073522-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3111508
—
NH
Enumeration date
01/18/2018
Last updated
04/20/2021
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