Provider Demographics
NPI:1053424762
Name:SARGENT, RACHAEL LYNNE (APRN)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LYNNE
Last Name:SARGENT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-0584
Mailing Address - Fax:603-225-5769
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:SUITE 205
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-0584
Practice Address - Fax:603-225-5769
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH05611123363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30344501Medicaid
VT1012862Medicaid
VT1012862Medicaid
NH30344501Medicaid