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NPI Code Detail

MEDICARE: KELLY NICOLE MCINTIRE FNP-BC

MEDICARE: KELLY NICOLE MCINTIRE FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner085437-23NH

General Provider Information

NPI Number : 1750009593
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY NICOLE MCINTIRE FNP-BC
Provider Business Mailing Address
First Line : 360 US HIGHWAY 1 BYP UNIT 102
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-7105
Country : US
Telephone Number : 603-410-6700
Fax Number : 603-309-9601
Provider Business Practice Location Address
First Line : 3 NASHUA RD
Second Line :
City : BEDFORD
State : NH
Zip : 03110-5515
Country : US
Telephone Number : 603-472-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2022
Last Update Date : 01/22/2026

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