Walsh, Mallory Jacob

Walsh, Mallory Jacob is an sole proprietor health care provider with primary practice located at 100 Main St Apt 205 , Pembroke NH 03275-1241. She recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Urgent Care, Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Walsh, Mallory Jacob can be contacted via phone (802) 274-8902.

Contact Information

Primary practice address
100 Main St Apt 205 Pembroke NH 03275-1241
Phone: (802) 274-8902
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Urgent Care 261QU0200X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1466 New Hampshire

Profile Details

NPI number 1780151001
LBN Legal business name Walsh, Mallory Jacob
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2018
Last updated Apr 18th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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