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General NPI Number Information
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NPI Number | 1194364083
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Entity Type | Organization
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Legal Business Name | CRANMORE HEALTH PARTNERS, LLC
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Dates
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Enumeration Date | 12/26/2019
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 15 US RTE 302 UNIT 1
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City | GLEN
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State | NH
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Zip | 03838-6300
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Country | US
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Telephone | 603-730-5356
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 125
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City | CENTER CONWAY
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State | NH
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Zip | 03813-0125
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Country | US
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Telephone | 603-387-4523
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Fax | 603-369-4658
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Authorized Official
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Title or Position | PARTNER
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Name | MS. KELLY C DEFEO
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Credential | CRNA, FNP
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Telephone | 603-387-4523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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