Provider Demographics
NPI:1235100223
Name:HANRAHAN, MELISSA B (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:B
Last Name:HANRAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:125 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-1508
Practice Address - Country:US
Practice Address - Phone:603-934-4259
Practice Address - Fax:603-934-1219
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH11626207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30202284Medicaid
NHRE6759Medicare ID - Type Unspecified
NH30202284Medicaid