Basic Information
Provider Information
NPI: 1952762346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARVILLE
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HARRIS
OtherFirstName: ASHLEY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 1
Mailing Information
Address1: 2 WALL ST STE 300
Address2:  
City: MANCHESTER
State: NH
PostalCode: 031011518
CountryCode: US
TelephoneNumber: 6036684111
FaxNumber:  
Practice Location
Address1: 2 WALL ST STE 300
Address2:  
City: MANCHESTER
State: NH
PostalCode: 031011518
CountryCode: US
TelephoneNumber: 6036684111
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/11/2016
LastUpdateDate: 03/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808X067484-21NHN Nursing Service ProvidersRegistered NursePsych/Mental Health
363LP0808X067484-23NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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