Provider Demographics
NPI:1326880626
Name:WHITTAKER, ALLISON SHEA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:SHEA
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:SHEA
Other - Last Name:MAZZOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 ALFRED PARK
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-8251
Mailing Address - Country:US
Mailing Address - Phone:610-716-0526
Mailing Address - Fax:
Practice Address - Street 1:29 RIVERSIDE ST UNIT B
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1396
Practice Address - Country:US
Practice Address - Phone:036-880-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH080011-21363LF0000X
MARN2306105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily