Individual
BENJAMIN FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
138 WEBSTER ST, MANCHESTER, NH 03104-2512
(603) 645-5977
Mailing address
42 ROLLING HILL DR, WEARE, NH 03281-5559
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
069735-23
NH
363LA2100X
Acute Care Nurse Practitioner
069735-23
NH
363LG0600X
Gerontology Nurse Practitioner
069735-23
NH
Other
Enumeration date
06/25/2019
Last updated
08/26/2021
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