Jean M Banville, ARNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Manchester, NH

NPI 1407035744 · NPPES record last updated Nov 8, 2007

Key facts

NPI
1407035744
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
051072-23 (NH)
Practice address
1228 Elm St
Manchester, NH 03101-1349
Phone
(603) 668-4111
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
021072-21NHMDPsychiatric/Mental Health Registered Nurse
051072-23NHMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 021072-21 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 051072-23 NH Yes

Addresses

Primary practice location

1228 Elm St
Manchester, NH 03101-1349

Mailing address

401 Cypress St
Manchester, NH 03103-3628
Phone (603) 668-4111

Other names

  • Jean M Hall, Cunningham Former name

Other providers in Manchester, NH

All providers in Manchester, NH · Psychiatric/Mental Health Nurse Practitioner in New Hampshire

Sources for this page

Verify at the official NPI Registry.