Provider Demographics
NPI:1386169423
Name:YOUNG, KELSEY (PHARMD RPH)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ROUTE 16
Mailing Address - Street 2:
Mailing Address - City:OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03864-7171
Mailing Address - Country:US
Mailing Address - Phone:603-539-4822
Mailing Address - Fax:
Practice Address - Street 1:571 NASHUA ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4924
Practice Address - Country:US
Practice Address - Phone:603-673-4341
Practice Address - Fax:603-673-4341
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist