Michelle Bolduc, FNP
Individual provider Active NPI Family Medicine Physician · Portsmouth, NH
NPI 1164005302 · NPPES record last updated May 5, 2021
Key facts
- NPI
- 1164005302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- F02210730 (NH)
- Practice address
- 278 Lafayette Rd Ste E5
Portsmouth, NH 03801-5455 - Phone
- (603) 433-8488
- Fax
- (603) 373-6009
- NPI assigned
- May 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F02210730 | NH | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | F02210730 | NH | Yes |
Addresses
Primary practice location
278 Lafayette Rd Ste E5
Portsmouth, NH 03801-5455
Mailing address
101 Shattuck Way
Newington, NH 03801-7876
Phone (603) 433-8488
Other providers in Portsmouth, NH
- Mary Beth Bloser
- Heather Kelley Blumenfeld
- Bryce Bobb
- Body by Monica, LLC
- Lisa Boldin
- Haley Boles
- Kayleigh Boll
- Georgie Marie Bond
- Vitali Bondar
- Crystal G Bonias
All providers in Portsmouth, NH · Family Medicine Physician 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 May 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.