Provider Demographics
NPI:1306645916
Name:QUELCH, MEGHAN (APRN)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:QUELCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 KENBERMA ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-6007
Mailing Address - Country:US
Mailing Address - Phone:802-989-3594
Mailing Address - Fax:
Practice Address - Street 1:835 HANOVER ST STE 305
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5401
Practice Address - Country:US
Practice Address - Phone:603-784-9012
Practice Address - Fax:603-784-9012
Is Sole Proprietor?:No
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH077865-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health