Provider Demographics
NPI:1003978487
Name:MACLEAN, KATHLEEN WHITE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:WHITE
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROCHESTER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1775
Mailing Address - Country:US
Mailing Address - Phone:603-335-2401
Mailing Address - Fax:
Practice Address - Street 1:245 ROCHESTER HILL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1775
Practice Address - Country:US
Practice Address - Phone:603-335-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH028254-23-03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHWHNPO597Medicare ID - Type Unspecified
NHS17848Medicare UPIN