Provider Demographics
NPI:1356729487
Name:WOOD, KELSEY (PA)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:200 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2504
Mailing Address - Country:US
Mailing Address - Phone:603-232-8925
Mailing Address - Fax:603-647-8593
Practice Address - Street 1:574 MIDDLE TURNPIKE EAST
Practice Address - Street 2:KELSEY WOOD
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3730
Practice Address - Country:US
Practice Address - Phone:860-646-4334
Practice Address - Fax:860-646-7020
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2017-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH1273363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical