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NPI Code Detail

MEDICARE: LINDA KELLEHER RN, BSN

MEDICARE: LINDA KELLEHER RN, BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN2309216MA

General Provider Information

NPI Number : 1043032220
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA KELLEHER RN, BSN
Provider Business Mailing Address
First Line : 960 MASSACHUSETTS AVE
Second Line : STE 2
City : BOSTON
State : MA
Zip : 02118
Country : US
Telephone Number : 617-414-5405
Fax Number :
Provider Business Practice Location Address
First Line : 312 BEDFORD ST
Second Line :
City : WHITMAN
State : MA
Zip : 02382-1859
Country : US
Telephone Number : 781-792-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2024
Last Update Date : 05/07/2026

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