Provider Demographics
NPI:1902870603
Name:CHRETIEN, DONNA L (ARNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:CHRETIEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 WEBSTER ST
Mailing Address - Street 2:SENIOR HEALTH PRIMARY CARE
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2512
Mailing Address - Country:US
Mailing Address - Phone:603-663-7030
Mailing Address - Fax:603-663-7039
Practice Address - Street 1:138 WEBSTER ST
Practice Address - Street 2:SENIOR HEALTH PRIMARY CARE
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2512
Practice Address - Country:US
Practice Address - Phone:603-663-7030
Practice Address - Fax:603-663-7039
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH029056-23-05363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH437940OtherCIGNA PIN
NHP06883OtherANTHEM REFERRING PIN
NHP06883OtherHARVARD PILGRIM PIN
NH029056OtherTUFTS PIN
NH30340828Medicaid
NH30340828Medicaid
NH437940OtherCIGNA PIN