Individual
AMY REBECCA BACON-FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 ELLIOT WAY, MANCHESTER, NH 03103-3502
(603) 663-2766
Mailing address
1 ELLIOT WAY, MANCHESTER, NH 03103-3599
(603) 663-3388
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
072006-23
NH
Other
Enumeration date
02/21/2011
Last updated
08/04/2023
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