Defeo, Kelly Catherine

Defeo, Kelly Catherine is an sole proprietor health care provider with primary practice located at 1857 White Mountain Hwy , North Conway NH 03860-5158. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Defeo, Kelly Catherine can be contacted via phone (603) 730-5356.

Contact Information

Primary practice address
1857 White Mountain Hwy North Conway NH 03860-5158
Phone: (603) 730-5356
Fax: (603) 730-5477
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 047170-23-11 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 04717023 New Hampshire

Profile Details

NPI number 1699757906
LBN Legal business name Defeo, Kelly Catherine
Credentials CRNA , APRN, PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 14th, 2005
Last updated Jul 29th, 2021 - about 3 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 1699757906 NPPES
New Hampshire MEDICAID 30342118

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