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NPI Code Detail

MEDICARE: KAILA N CONNOLLY RN, MSN, FNP-C

MEDICARE: KAILA N CONNOLLY RN, MSN, FNP-C
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 PractitionerRN2313891MA
2163W00000XRegistered NurseRN2313891MA

General Provider Information

NPI Number : 1609375971
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILA N CONNOLLY RN, MSN, FNP-C
Provider Business Mailing Address
First Line : 127 M ST
Second Line :
City : BOSTON
State : MA
Zip : 02127-3176
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 736 CAMBRIDGE ST
Second Line :
City : BRIGHTON
State : MA
Zip : 02135-2907
Country : US
Telephone Number : 617-789-2102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 04/07/2026

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