Healthcare Provider Details

I. General information

NPI: 1215862180
Provider Name (Legal Business Name): LAUREN KEETCH NEAR CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ALEXA KEETCH

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 CENTRAL AVE
DOVER NH
03820-2526
US

IV. Provider business mailing address

789 CENTRAL AVE
DOVER NH
03820-2526
US

V. Phone/Fax

Practice location:
  • Phone: 801-792-6412
  • Fax:
Mailing address:
  • Phone: 801-792-6412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: