Healthcare Provider Details
I. General information
NPI: 1093392227
Provider Name (Legal Business Name): KELSEY CARD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2021
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
248 PLEASANT ST STE 2600
CONCORD NH
03301-7529
US
IV. Provider business mailing address
248 PLEASANT ST STE 2600
CONCORD NH
03301-7529
US
V. Phone/Fax
- Phone: 603-224-1929
- Fax:
- Phone: 603-401-9822
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 32154 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: