Individual
DR. KELLY M MACMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
168 KINSLEY ST STE 20, NASHUA, NH 03060-3634
(603) 883-3365
(603) 883-5758
Mailing address
C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8695
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
11599
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3076899
—
NH
Enumeration date
12/16/2005
Last updated
10/16/2021
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