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General NPI Number Information
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NPI Number | 1033466784
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Entity Type | Organization
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Legal Business Name | KEADY FAMILY PRACTICE, LLC
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 214 WASHINGTON ST
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City | CLAREMONT
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State | NH
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Zip | 03743-5512
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Country | US
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Telephone | 603-863-7777
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Fax | 603-769-3406
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Provider Business Mailing Address
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Address Line | 214 WASHINGTON ST
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City | CLAREMONT
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State | NH
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Zip | 03743-5512
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Country | US
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Telephone | 603-863-7777
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. JAMES PATRICK KEADY JR.
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Credential |
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Telephone | 603-826-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 052532-23
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License Number State | NH
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