Healthcare Provider Details

I. General information

NPI: 1326951831
Provider Name (Legal Business Name): KELLY ANN BEAULIEU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 PITTSFIELD RD STE 9
LENOX MA
01240-2185
US

IV. Provider business mailing address

88 VALENTINE RD
PITTSFIELD MA
01201-3004
US

V. Phone/Fax

Practice location:
  • Phone: 518-560-0750
  • Fax:
Mailing address:
  • Phone: 518-560-0750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number2307646
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: