Provider Demographics
NPI:1619724085
Name:JONES, KELLY LYN (MCHES)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:LYN
Last Name:JONES
Suffix:
Gender:F
Credentials:MCHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3801
Mailing Address - Country:US
Mailing Address - Phone:603-566-3838
Mailing Address - Fax:
Practice Address - Street 1:29 HAZEN DR FL 3
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6510
Practice Address - Country:US
Practice Address - Phone:603-856-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32605174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator