Provider Demographics
NPI:1386774545
Name:SAMPSON, DEBORAH ANN (APRN)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 COMMERCE ST SUITE 302
Mailing Address - Street 2:CONCORD HOSPITAL OCCUPATIONAL HEALTH
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-0000
Mailing Address - Country:US
Mailing Address - Phone:603-230-1220
Mailing Address - Fax:
Practice Address - Street 1:60 COMMERCE ST SUITE 302
Practice Address - Street 2:CONCORD HOSPITAL OCCUPATIONAL HEALTH
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-0000
Practice Address - Country:US
Practice Address - Phone:603-230-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH020421-23-03363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNP458601OtherMEDICARE PTAN
NH30342961Medicaid