Individual
KEELY FITZGERALD HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
50 MICHELS WAY UNIT 102, LONDONDERRY, NH 03053-3499
(603) 537-1300
Mailing address
14B TSIENNETO RD, DERRY, NH 03038-1560
(603) 537-1300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3051
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205142924
NPI
UT
01
—
13520505
CAQH
UT
01
—
8035121-1206
UT MEDICAL LICENSE
UT
01
—
8035121-8906
UT CONTROLLED SUBSTANCE
UT
01
—
U000088825
PTAN
UT
01
—
UT014851
UT MEDICAL LIABILITY
UT
Enumeration date
08/19/2010
Last updated
09/17/2025
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