Provider Demographics
NPI:1467272054
Name:KEATING, KATHRYN BARR (PMHNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BARR
Last Name:KEATING
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-6044
Mailing Address - Country:US
Mailing Address - Phone:603-447-2111
Mailing Address - Fax:603-447-1021
Practice Address - Street 1:25 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-6142
Practice Address - Country:US
Practice Address - Phone:603-447-2111
Practice Address - Fax:603-447-1021
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH071925-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health