Individual
MS. KATHLEEN P FANTOZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1590 UNION ST, MANCHESTER, NH 03104-1768
(603) 860-8905
Mailing address
1590 UNION ST, MANCHESTER, NH 03104-1768
(603) 860-8905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2020015527
NH
363LF0000X
Family Nurse Practitioner
Primary
2020015527
NH
Other
Enumeration date
08/05/2020
Last updated
09/04/2020
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