Basic Information
Provider Information
NPI: 1154864734
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TROTTER
FirstName: MAGGIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 KEEWAYDIN DR
Address2:  
City: SALEM
State: NH
PostalCode: 030792839
CountryCode: US
TelephoneNumber: 8009952673
FaxNumber: 8889796551
Practice Location
Address1: 2 KEEWAYDIN DR
Address2:  
City: SALEM
State: NH
PostalCode: 030792839
CountryCode: US
TelephoneNumber: 8009952673
FaxNumber: 8889796551
Other Information
ProviderEnumerationDate: 11/30/2016
LastUpdateDate: 11/30/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XLPN-23228NMY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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