1841258209 NPI number — KRISTIN ANN KEEFE M.D.

Table of content: KRISTIN ANN KEEFE M.D. (NPI 1841258209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841258209 NPI number — KRISTIN ANN KEEFE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEEFE
Provider First Name:
KRISTIN
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLARKIN
Provider Other First Name:
KRISTIN
Provider Other Middle Name:
KEEFE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841258209
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ELLIOT HOSPITAL
Provider Second Line Business Mailing Address:
PALLIATIVE CARE
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-663-2266
Provider Business Mailing Address Fax Number:
603-663-2273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PALLIATIVE CARE
Provider Second Line Business Practice Location Address:
445 CYPRESS ST SUITE 8
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-663-4023
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LH0002X , with the licence number:  212947 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 212947 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VH0002X , with the licence number: Q6337 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VH0002X , with the licence number: 10951 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VX0201X , with the licence number: 212947 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VH0002X , with the licence number: G83013 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 97173903 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 725746 . This is a "TUFTS MEDICARE PREFERRED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 355303401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 355303402 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 725746 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".