Individual
JEANNE D CHAREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
133 PLEASANT ST, BERLIN, NH 03570-2006
(603) 752-2040
(603) 752-7797
Mailing address
133 PLEASANT ST, BERLIN, NH 03570-2006
(603) 752-2040
(603) 752-7797
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0139452302
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0139452302
STATE LICENSE #
NH
01
—
020350051
FEDERAL TAX ID
—
01
—
16009
CIGNA HEALTHCARE
NH
01
—
2308433YPNH01
ANTHEM BC/BS
NH
05
—
30005542
—
NH
05
—
3071895
—
NH
01
—
5830418
AETNA
—
Enumeration date
08/09/2005
Last updated
03/07/2023
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