Individual
CHARLENE KREIENSIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
724 N MAIN ST, LACONIA, NH 03246-2742
(603) 524-5151
Mailing address
724 N MAIN ST, LACONIA, NH 03246-2742
(603) 524-5151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0377
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30331636
—
NH
Enumeration date
08/13/2006
Last updated
07/08/2007
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