Provider Demographics
NPI:1548295595
Name:FEENEY, ADELE SUSAN (ARNP)
Entity type:Individual
Prefix:
First Name:ADELE
Middle Name:SUSAN
Last Name:FEENEY
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:LIBERTY PARK UNITS 9 & 10
Mailing Address - Street 2:282 ROUTE 101
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031
Mailing Address - Country:US
Mailing Address - Phone:603-249-8883
Mailing Address - Fax:603-249-1107
Practice Address - Street 1:LIBERTY PARK UNITS 9 & 10
Practice Address - Street 2:282 ROUTE 101
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031
Practice Address - Country:US
Practice Address - Phone:603-249-8883
Practice Address - Fax:603-249-1107
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0407352303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH201717114OtherTAX ID
NH2303097YPNH01OtherBC/BS NH IPN
NH208649299OtherTAX ID
NH0407352303OtherS OF NH BON LIC #
NHMF0374734OtherDEA
NH2303097YPNH01OtherBC/BS NH IPN
NH208649299OtherTAX ID