Healthcare Provider Details

I. General information

NPI: 1942607759
Provider Name (Legal Business Name): KELLEY WATKINS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W BROADWAY
DERRY NH
03038-2375
US

IV. Provider business mailing address

841 CENTRAL ST STE 101
FRANKLIN NH
03235-2053
US

V. Phone/Fax

Practice location:
  • Phone: 603-426-3035
  • Fax: 603-404-2482
Mailing address:
  • Phone: 603-934-1464
  • Fax: 603-536-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number039552-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number039552-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: