Provider Demographics
NPI:1841258209
Name:KEEFE, KRISTIN ANN (MD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANN
Last Name:KEEFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:KEEFE
Other - Last Name:CLARKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:ELLIOT HOSPITAL
Mailing Address - Street 2:PALLIATIVE CARE
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103
Mailing Address - Country:US
Mailing Address - Phone:603-663-2266
Mailing Address - Fax:603-663-2273
Practice Address - Street 1:PALLIATIVE CARE
Practice Address - Street 2:445 CYPRESS ST SUITE 8
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-663-4023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212947207LH0002X, 207V00000X, 207VX0201X
TXQ6337207VH0002X
NH10951207VH0002X
CAG83013207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine
No207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA97173903OtherNETWORK HEALTH
MA725746OtherTUFTS MEDICARE PREFERRED
TX355303401Medicaid
TX355303402Medicaid
MA725746OtherTUFTS HEALTH PLAN
TX355303401Medicaid
TX461597YMGJMedicare PIN