Healthcare Provider Details

I. General information

NPI: 1124679352
Provider Name (Legal Business Name): DANA KILLEEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2019
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LINCOLN ST
FRAMINGHAM MA
01702-6358
US

IV. Provider business mailing address

17 MURIEL LN
MILFORD MA
01757-1551
US

V. Phone/Fax

Practice location:
  • Phone: 508-838-1444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9291
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9291
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2688
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: