Provider Demographics
NPI:1770547424
Name:SUNNERBERG, MAUREEN (ARNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SUNNERBERG
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 1:207 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1835
Mailing Address - Country:US
Mailing Address - Phone:603-659-3106
Mailing Address - Fax:603-659-2091
Practice Address - Street 1:207 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWMARKET
Practice Address - State:NH
Practice Address - Zip Code:03857-1835
Practice Address - Country:US
Practice Address - Phone:603-659-3106
Practice Address - Fax:603-659-2091
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN182929363LF0000X
NH036928-23363L00000X
MA182929163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP0892Medicare ID - Type Unspecified
MAS49407Medicare UPIN