Basic Information
| Provider Information | |||||||||
| NPI: | 1851817522 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNTLEY-SMITH | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | ANDREA | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 590 COURT STREET | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - FAMILY MEDICINE | ||||||||
| City: | KEENE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033545400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 590 COURT ST | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - FAMILY MEDICINE | ||||||||
| City: | KEENE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034311719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033545400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2017 | ||||||||
| LastUpdateDate: | 12/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 042354-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207Q00000X | 042354-23 | NH | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.