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General NPI Number Information
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NPI Number | 1104130178
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Entity Type | Individual
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Provider Name | KELLY NICOLE STINSON MD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2010
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 15 DARTMOUTH DR UNIT 102
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City | AUBURN
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State | NH
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Zip | 03032-3982
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Country | US
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Telephone | 781-572-2759
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Fax |
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Provider Business Mailing Address
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Address Line | 15 DARTMOUTH DR UNIT 102
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City | AUBURN
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State | NH
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Zip | 03032-3982
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Country | US
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Telephone | 781-572-2759
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0060655
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 067261
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 26802
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ACKNOWLEDGMENTLETTER
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | 23900
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License Number State | NH
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