Provider Demographics
NPI:1306805635
Name:MINARD, FAITH E (ARNP)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:E
Last Name:MINARD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 CYPRESS STREET, SUITE 8
Mailing Address - Street 2:MANCHESTER COUNSELING SERVICES
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103
Mailing Address - Country:US
Mailing Address - Phone:603-668-4079
Mailing Address - Fax:603-663-8605
Practice Address - Street 1:445 CYPRESS STREET, SUITE 8
Practice Address - Street 2:MANCHESTER COUNSELING SERVICES
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-668-4079
Practice Address - Fax:603-663-8605
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH021701-23-08363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009547Medicaid
NH295852OtherCIGNA BH PIN
NH4008035Y0NH01OtherANTHEM ACES #
P00014340OtherRR MEDICARE
NH30009547Medicaid
NH295852OtherCIGNA BH PIN