Basic Information
| Provider Information | |||||||||
| NPI: | 1750733630 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERRIS | ||||||||
| FirstName: | LIZA | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 FOUNDRY ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033015421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032280071 | ||||||||
| FaxNumber: | 6032287014 | ||||||||
| Practice Location | |||||||||
| Address1: | 18 FOUNDRY ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033015421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032280071 | ||||||||
| FaxNumber: | 6032287014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2016 | ||||||||
| LastUpdateDate: | 07/29/2016 | ||||||||
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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 | 363LF0000X | 064410-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 064410-21 | NH | N | Nursing Service Providers | Registered Nurse |
No ID Information.