Healthcare Provider Details

I. General information

NPI: 1508954850
Provider Name (Legal Business Name): JANE BEATRICE KELSEY RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 NORTHAMPTON ST
HOLYOKE MA
01040-1919
US

IV. Provider business mailing address

1 TEMPLE AVE
GREENFIELD MA
01301-3914
US

V. Phone/Fax

Practice location:
  • Phone: 413-532-0926
  • Fax: 413-532-0928
Mailing address:
  • Phone: 413-773-9692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number195710
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: