Healthcare Provider Details

I. General information

NPI: 1891917878
Provider Name (Legal Business Name): KATHLEEN KAMMERAAD R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1458 LAKESHORE ROAD
GILFORD NH
03249
US

IV. Provider business mailing address

2393 LAKESHORE ROAD UNIT 31
GILFORD NH
03249
US

V. Phone/Fax

Practice location:
  • Phone: 603-528-8055
  • Fax:
Mailing address:
  • Phone: 603-293-8365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR1787
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: