Healthcare Provider Details

I. General information

NPI: 1922022540
Provider Name (Legal Business Name): JEANNA H WALSH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT STREET NEW HAMPSHIRE ONCOLOGY HEMATOLOGY PA
CONCORD NH
03301
US

IV. Provider business mailing address

11 KIMBALL DR UNIT 125
HOOKSETT NH
03106-2623
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-2556
  • Fax: 603-226-5821
Mailing address:
  • Phone: 603-622-6484
  • Fax: 603-226-5821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number13523
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: