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NPI Code Detail

MEDICARE: KELLY OUM

MEDICARE: KELLY OUM
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
1163W00000XRegistered NurseRN2324758MA

General Provider Information

NPI Number : 1104775394
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY OUM
Provider Business Mailing Address
First Line : 67 SILVER ST
Second Line :
City : HAVERHILL
State : MA
Zip : 01832-4542
Country : US
Telephone Number : 978-888-4034
Fax Number :
Provider Business Practice Location Address
First Line : 14 INGALLS CT
Second Line :
City : METHUEN
State : MA
Zip : 01844-3717
Country : US
Telephone Number : 978-686-2807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “ KELLY OUM ” Practice Location

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