Provider Demographics
NPI:1497416564
Name:KEARNS, CASSIDY (CPHT)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:KEARNS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ALLENSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ALLENSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03275-2201
Mailing Address - Country:US
Mailing Address - Phone:603-485-5935
Mailing Address - Fax:
Practice Address - Street 1:26 ALLENSTOWN RD
Practice Address - Street 2:
Practice Address - City:ALLENSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03275-2201
Practice Address - Country:US
Practice Address - Phone:603-485-5935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHT-122142183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician