Healthcare Provider Details

I. General information

NPI: 1144509241
Provider Name (Legal Business Name): KASEY E TALON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 OLD ROLLINSFORD RD STE 301
DOVER NH
03820
US

IV. Provider business mailing address

PO BOX 412503
BOSTON MA
02241-1543
US

V. Phone/Fax

Practice location:
  • Phone: 603-740-2253
  • Fax: 603-609-6530
Mailing address:
  • Phone: 617-726-3884
  • Fax: 833-944-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number056426-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: