Basic Information
| Provider Information | |||||||||
| NPI: | 1811393440 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRUE | ||||||||
| FirstName: | JESSYCA | ||||||||
| MiddleName: | |||||||||
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| Credential: | NP-C | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | TASLER | ||||||||
| OtherFirstName: | JESSYCA | ||||||||
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| OtherCredential: | NP-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 103 EAGLE RIDGE RD UNIT 1 | ||||||||
| Address2: | |||||||||
| City: | SANDOWN | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038732373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137581618 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 PARKLAND DR | ||||||||
| Address2: | |||||||||
| City: | DERRY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030382746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034212220 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2014 | ||||||||
| LastUpdateDate: | 03/22/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP9352307 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 078599-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.