Kathleen T. Moen

Individual provider Active NPI Pediatric Registered Nurse · Bow, NH

NPI 1619798550 · NPPES record last updated Oct 23, 2024

Key facts

NPI
1619798550
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Registered Nurse 163WP0200X
License
075986-21 (NH)
Practice address
86 Robinson Rd
Bow, NH 03304-3820
Phone
(603) 491-7468
NPI assigned
Oct 23, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
075986-21NHMDPediatric Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 075986-21 NH Yes

Addresses

Primary practice location

86 Robinson Rd
Bow, NH 03304-3820

Mailing address

86 Robinson Rd
Bow, NH 03304-3820
Phone (603) 491-7468

Other providers in Bow, NH

All providers in Bow, NH · Pediatric Registered Nurse in New Hampshire

Sources for this page

Verify at the official NPI Registry.