Individual
MRS. KEIRA ROSE PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
248 PLEASANT ST STE 2800, CONCORD, NH 03301-7529
(603) 224-5200
(603) 227-7559
Mailing address
248 PLEASANT ST STE 2800, CONCORD, NH 03301-7529
(603) 224-5200
(603) 227-7559
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1398
NH
363A00000X
Physician Assistant
2353
MA
363AS0400X
Surgical Physician Assistant
2353
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002193
MEDICARE PTAN
MA
Enumeration date
08/23/2007
Last updated
08/09/2023
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