Healthcare Provider Details

I. General information

NPI: 1932930252
Provider Name (Legal Business Name): KERA A MAHONEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERA ANN KELLY APRN

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 ARMORY RD
MILFORD NH
03055-3405
US

IV. Provider business mailing address

PO BOX 810
HANOVER NH
03755-0810
US

V. Phone/Fax

Practice location:
  • Phone: 603-673-2515
  • Fax:
Mailing address:
  • Phone: 603-308-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number082839-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: