Healthcare Provider Details

I. General information

NPI: 1265989438
Provider Name (Legal Business Name): KERRY J O'HARA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRY J WULPERN APRN

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SOUTH ST
HANOVER NH
03755-2163
US

IV. Provider business mailing address

12 SOUTH ST
HANOVER NH
03755-2163
US

V. Phone/Fax

Practice location:
  • Phone: 603-359-3508
  • Fax: 229-509-9343
Mailing address:
  • Phone: 603-359-3508
  • Fax: 229-509-9343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number063114-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number063114-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: