Provider Demographics
NPI:1861878571
Name:MIRABELLO, SUSAN F (APRN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:F
Last Name:MIRABELLO
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:875 ELM ST APT 507
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2124
Mailing Address - Country:US
Mailing Address - Phone:603-663-6478
Mailing Address - Fax:603-663-8015
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6478
Practice Address - Fax:603-663-8015
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2018-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH056350-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner