Provider Demographics
NPI:1215609235
Name:GESEN, STUART MACFARLANE (RN)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:MACFARLANE
Last Name:GESEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2934
Mailing Address - Country:US
Mailing Address - Phone:603-225-0855
Mailing Address - Fax:603-225-0869
Practice Address - Street 1:51 S CURTISVILLE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5909
Practice Address - Country:US
Practice Address - Phone:602-225-0855
Practice Address - Fax:603-225-0869
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH061118-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3073388Medicaid
NH307338Medicaid