Provider Demographics
NPI:1396446696
Name:ROBICHAUD, JULIE ANN (PMHAPRN-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:ROBICHAUD
Suffix:
Gender:F
Credentials:PMHAPRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUCKTHORN RD
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2785
Mailing Address - Country:US
Mailing Address - Phone:603-275-0800
Mailing Address - Fax:
Practice Address - Street 1:69 BAY ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-3005
Practice Address - Country:US
Practice Address - Phone:603-232-6987
Practice Address - Fax:603-935-9056
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NH033878-23363LP0808X
MARN177531363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1497094296Medicaid