Provider Demographics
NPI:1871637116
Name:KENNEY, ROSALYN (NP)
Entity Type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:
Last Name:KENNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2846
Mailing Address - Country:US
Mailing Address - Phone:603-386-0100
Mailing Address - Fax:603-386-0076
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2846
Practice Address - Country:US
Practice Address - Phone:603-386-0100
Practice Address - Fax:603-386-0076
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0489282303363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH23YP05038NH02OtherBCBS
NHNP3838Medicare ID - Type Unspecified
NHP63759Medicare UPIN