Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MALLORY JACOB WALSH
Active Sole ProprietorMALLORY JACOB WALSH is a Physician Assistant healthcare provider located in PEMBROKE, New Hampshire. NPI 1780151001 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · PEMBROKE, NH
Registration Details
- NPI Number
- 1780151001
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 24, 2018 (7.8401062530626 yrs)
- Last Updated
- Apr 18, 2019
- License
-
1466 (NH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
100 MAIN ST APT 205PEMBROKE, NH, 032751241Browse NH providers · Browse ZIP 03275
- Phone
- 8022748902
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in PEMBROKE, NH
| Name | Credential | NPI |
|---|---|---|
| CYNTHIA ANNE TRANCHEMONTAGNE | PA-C | 1144609595 |
| TERESA CIMINI | — | 1295692663 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.