Active NPI
Debra Ebersole, APRN-FNP
- Family Nurse Practitioner
- Manchester, NH
National Provider Identifier
1801263496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 043020-23
- Practice address
- 30 Canton St
Suite 6
Manchester, NH 03103-3524 - Phone
- (603) 624-1638
- NPI assigned
- Aug 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 043020-23 | NH | Primary |
Addresses
Primary practice location
30 Canton St
Suite 6
Manchester, NH 03103-3524
Mailing address
30 Canton St
Suite 6
Manchester, NH 03103-3524
Phone (603) 624-1638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043020-23 | NH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1801263496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CANTON ST",
"address_2": "SUITE 6",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031033524",
"telephone_number": "603-624-1638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 CANTON ST",
"address_2": "SUITE 6",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031033524",
"telephone_number": "603-624-1638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERSOLE",
"first_name": "DEBRA",
"credential": "APRN-FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-31",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NH",
"license": "043020-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.