Healthcare Provider Details

I. General information

NPI: 1730271966
Provider Name (Legal Business Name): KATHLEEN WOOD HEDBERG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN M WOOD HEDBERG APRN

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL RD SMH DBA: WOUND CARE & HYPERBARIC MEDICINE
PLYMOUTH NH
03264-1126
US

IV. Provider business mailing address

16 HOSPITAL RD SPEARE MEMORIAL HOSPITAL
PLYMOUTH NH
03264-1126
US

V. Phone/Fax

Practice location:
  • Phone: 603-536-1120
  • Fax:
Mailing address:
  • Phone: 603-536-1120
  • Fax: 603-536-2017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0439812303
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: