Doherty, Kelly A

Doherty, Kelly A is an sole proprietor health care provider with primary practice located at 15 Constitution Dr Fl 1 , Bedford NH 03110-6042. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Doherty, Kelly A can be contacted via phone (603) 923-9119.

Contact Information

Primary practice address
15 Constitution Dr Fl 1 Bedford NH 03110-6042
Phone: (603) 923-9119
Fax: (603) 749-2453
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 04891221 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 151176 Maine
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 101.0135067 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 048912-23 New Hampshire

Profile Details

NPI number 1588642607
LBN Legal business name Doherty, Kelly A
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2006
Last updated Mar 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588642607 NPPES
New Hampshire MEDICAID 30341526

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