Nicole A. Conceicao, APRN
Individual provider Active NPI Nurse Practitioner · Warner, NH
NPI 1033634779 · NPPES record last updated Nov 1, 2018
Key facts
- NPI
- 1033634779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 065387-23 (NH)
- Practice address
- 2 E Main St Unit 2
Warner, NH 03278-4421 - Phone
- (603) 456-6106
- Fax
- (603) 227-7566
- NPI assigned
- Aug 3, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4713 Kentucky Ave
Nashville, TN 37209-2207
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NH, ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171018000979 | NH | Practitioner - Nurse Practitioner | 7315213477 | |
| I20230505000966 | ME | Practitioner - Nurse Practitioner | 7315213477 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orient Health of Maine LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 065387-23 | NH | Yes |
Addresses
Primary practice location
2 E Main St Unit 2
Warner, NH 03278-4421
Mailing address
2 E Main St Unit 2
Warner, NH 03278-4421
Phone (603) 456-6106
Other names
- Nicole A. Boutwell
Other providers in Warner, NH
- Theodore M Austin
- Cynthia Lee Bliss-Kaplan
- Morgan L Church
- Catherine F. Creed
- Amanda Arue Fernandez
- Angela Paige Goldman Klingler
- Daphne Morgan Hall
- Lucretia Hanna
All providers in Warner, NH · Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.