| Diabetes And Lifestyle Management, Llc | |
|
15 Tsienneto Rd Ste 200 Derry NH 03038-1557 | |
| (603) 552-3309 | |
| (603) 965-4177 |
| Full Name | Diabetes And Lifestyle Management, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 15 Tsienneto Rd Ste 200, Derry, New Hampshire |
| Authorized Official Name and Position | James Merville Harris (DIRECTOR) |
| Authorized Official Contact | 6035523309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Lifestyle Management, Llc 15 Tsienneto Rd Ste 200 Derry NH 03038-1557 Ph: (603) 552-3309 | Diabetes And Lifestyle Management, Llc 15 Tsienneto Rd Ste 200 Derry NH 03038-1557 Ph: (603) 552-3309 |
| NPI Number | 1649649021 |
|---|---|
| Provider Enumeration Date | 09/16/2015 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 9638488927 |
|---|---|
| Medicare Enrollment ID | O20151028000992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649649021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 041658-23 (New Hampshire) | Primary |
| Provider Name | James M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932186475 PECOS PAC ID: 4486626215 Enrollment ID: I20040811000704 |
| Provider Name | Shari L Sarris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871088286 PECOS PAC ID: 7719238385 Enrollment ID: I20180920000719 |
| Provider Name | Colleen Skeirik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437813979 PECOS PAC ID: 1254720071 Enrollment ID: I20220921001555 |
| Provider Name | Jennifer Lynn Godek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548929235 PECOS PAC ID: 5395121545 Enrollment ID: I20220926002878 |
| Provider Name | Sarah Michelle Tremblay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023776333 PECOS PAC ID: 7618343070 Enrollment ID: I20221026002454 |
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