Healthcare Provider Details

I. General information

NPI: 1043903958
Provider Name (Legal Business Name): KELLI CHANDLER MCKAY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2023
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MCGREGOR ST STE 204
MANCHESTER NH
03102-3733
US

IV. Provider business mailing address

66 BEAR HILL RD
CHICHESTER NH
03258-6201
US

V. Phone/Fax

Practice location:
  • Phone: 603-314-7595
  • Fax:
Mailing address:
  • Phone: 478-288-7929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN2357108
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number081573-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: