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Individual

KELLEY JEAN SHEPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L, CHT

Contact information

Practice address
89 MAIN ST, PLAISTOW, NH 03865-3010
(603) 382-3031
(603) 382-5580
Mailing address
89 MAIN ST, PLAISTOW, NH 03865-3010
(603) 382-3031
(603) 382-5580

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
684
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0707724
MA
01
13Y009078NH01
ANTHEM
NH
01
30414644
EDS
01
5325560
CIGNA HEALTHCARE
NH
01
5686743
FIRST HEALTH AND/OR CCN
NH
01
655894
TUFTS
01
AA50990
HARVARD PILGRIM
MA
01
OT0159
BLUE CROSS BLUE SHIELD
MA
01
P00356772
RAILROAD MEDICARE
Enumeration date
05/16/2006
Last updated
04/13/2015
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