Healthcare Provider Details

I. General information

NPI: 1528318565
Provider Name (Legal Business Name): MEGHAN C BARON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHAN CHRISTINA KENNEY PA-C

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CRESCENT ST
PENACOOK NH
03303-1412
US

IV. Provider business mailing address

4 CRESCENT ST
PENACOOK NH
03303-1412
US

V. Phone/Fax

Practice location:
  • Phone: 603-753-4302
  • Fax: 603-753-6213
Mailing address:
  • Phone: 603-753-4302
  • Fax: 603-753-6213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1453
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0915
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: