Provider Demographics
NPI:1699709097
Name:DILLON, ROBERT EDWARD JR (MS, ARNP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWARD
Last Name:DILLON
Suffix:JR
Gender:M
Credentials:MS, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:428 LAFAYETTE RD APT 101
Mailing Address - Street 2:PO BOX 171
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2268
Mailing Address - Country:US
Mailing Address - Phone:603-395-1724
Mailing Address - Fax:888-979-8717
Practice Address - Street 1:428 LAFAYETTE RD APT 101
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2268
Practice Address - Country:US
Practice Address - Phone:603-395-1724
Practice Address - Fax:888-979-8717
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH046771-23363LP0808X, 363LF0000X, 163WA0400X, 163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30344609Medicaid
NHQ72374Medicare UPIN
NH30344609Medicaid