Provider Demographics
NPI:1306237227
Name:DUBE, KAILEIGH D (PA-C)
Entity type:Individual
Prefix:
First Name:KAILEIGH
Middle Name:D
Last Name:DUBE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAILEIGH
Other - Middle Name:D
Other - Last Name:GRAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-382-4972
Mailing Address - Fax:603-382-9305
Practice Address - Street 1:127 PLAISTOW RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2811
Practice Address - Country:US
Practice Address - Phone:603-382-4972
Practice Address - Fax:603-382-9305
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1068363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3100307Medicaid