Healthcare Provider Details

I. General information

NPI: 1467272054
Provider Name (Legal Business Name): KATHRYN BARR KEATING PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 EASTMAN RD STE B
CENTER CONWAY NH
03813-4219
US

IV. Provider business mailing address

626 EASTMAN RD STE B
CENTER CONWAY NH
03813-4219
US

V. Phone/Fax

Practice location:
  • Phone: 603-447-2111
  • Fax: 603-447-1021
Mailing address:
  • Phone: 603-447-2111
  • Fax: 603-447-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number071925-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: