Individual
MRS. SUSAN LEE REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1 MEDICAL CENTER DR, 5L, LEBANON, NH 03756-1000
(603) 653-9302
(603) 650-0902
Mailing address
12 BOWERS RD., HARTLAND, VT 05048-0295
(802) 436-2564
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
015400-23-04
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004947
—
VT
05
—
30008606
—
NH
Enumeration date
07/24/2006
Last updated
07/08/2007
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