Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wild Prairie Primary Care PLLC

Organization Internal Medicine Physician · NPI 1720961865

Wild Prairie Primary Care PLLC is an Internal Medicine Physician in Lebanon, New Hampshire. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

240 Mechanic St Ste 201
Lebanon, NH 03766-2617
Phone: (971) 235-9657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1720961865
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Juniper Vale — Owner · (603) 727-9175
NPI enumeratedJuly 28, 2025
Last updated in NPPESOctober 18, 2025
Certification dateOctober 18, 2025
Mailing address240 Mechanic St Ste 201, Lebanon, NH 03766-2617

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