Basic Information
| Provider Information | |||||||||
| NPI: | 1033229596 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDONALD | ||||||||
| FirstName: | BRITTANIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FARNSWORTH | ||||||||
| OtherFirstName: | BRITTANIA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 706 | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032160706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034818757 | ||||||||
| FaxNumber: | 6032382163 | ||||||||
| Practice Location | |||||||||
| Address1: | 16 HOSPITAL ROAD | ||||||||
| Address2: | PLYMOUTH OB/GYN | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035361104 | ||||||||
| FaxNumber: | 6035367260 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 10/12/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 0597 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 3071599 | 05 | NH | MEDICAID |