Individual
ANGELA K DEFORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
580 SAINT JOHNSBURY RD, LITTLETON, NH 03561-3437
(603) 444-0997
(603) 444-0482
Mailing address
580 SAINT JOHNSBURY RD, LITTLETON, NH 03561-3437
(603) 444-0997
(603) 444-0482
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0612
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80300008
—
NH
Enumeration date
12/14/2006
Last updated
07/08/2007
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