Basic Information
| Provider Information | |||||||||
| NPI: | 1770844144 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FINN | ||||||||
| FirstName: | KYLEE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 SAINT JOHNSBURY RD | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035613442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034447070 | ||||||||
| FaxNumber: | 6034442769 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 SAINT JOHNSBURY RD | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035613442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034447070 | ||||||||
| FaxNumber: | 6034442769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2012 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 17946 | NV | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 20636 | NH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1770844144 | 05 | NV | MEDICAID | 14240674 | 01 | CAQH | OTHER |