Individual
MS. THERESA JEANNE DESILETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
590 COURT ST, INTERNAL MEDICINE, KEENE, NH 03431-1719
(603) 354-5454
Mailing address
7 ALGONQUIN DR, KEENE, NH 03431-1810
(603) 355-1548
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0462352305
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ONP2165
—
VT
Enumeration date
10/17/2006
Last updated
07/08/2007
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