Healthcare Provider Details

I. General information

NPI: 1356062004
Provider Name (Legal Business Name): KALEIGH SILVA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALEIGH LUBERA

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 STATE ST STE 5
BOSTON MA
02109-2906
US

IV. Provider business mailing address

109 STATE ST STE 5
BOSTON MA
02109-2906
US

V. Phone/Fax

Practice location:
  • Phone: 617-505-1520
  • Fax: 617-928-8401
Mailing address:
  • Phone: 617-505-1520
  • Fax: 617-928-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2356357
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN10003514
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN03260
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN56317
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: