Healthcare Provider Details

I. General information

NPI: 1780139600
Provider Name (Legal Business Name): KELSEY HUTCHINSON PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2016
Last Update Date: 08/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 MAMMOTH RD
LONDONDERRY NH
03053-3208
US

IV. Provider business mailing address

177 MAMMOTH RD
LONDONDERRY NH
03053-3208
US

V. Phone/Fax

Practice location:
  • Phone: 603-432-2657
  • Fax:
Mailing address:
  • Phone: 603-432-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4216
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: