Provider Demographics
NPI:1740224443
Name:KIEFFER, KELLY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:KIEFFER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC - INTERNAL MEDICINE
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-653-9500
Mailing Address - Fax:603-650-0915
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC - INTERNAL MEDICINE
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9500
Practice Address - Fax:603-650-0915
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH10904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30200780Medicaid
VT0RE5701Medicaid
VT0RE5701Medicaid
NHMX3960Medicare PIN
NHMX3959Medicare PIN