Provider Demographics
NPI:1447960851
Name:SHANLEY, CIERRA S (FNP-C)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:S
Last Name:SHANLEY
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:CIERRA
Other - Middle Name:S
Other - Last Name:DUMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:1 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2585
Practice Address - Country:US
Practice Address - Phone:603-942-3600
Practice Address - Fax:603-630-1009
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH083852-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH083852-23OtherSTATE LICENSE