Healthcare Provider Details

I. General information

NPI: 1649757360
Provider Name (Legal Business Name): KELLY ANN MURPHY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 PROSPECT ST UNIT 1
NANTUCKET MA
02554-4396
US

IV. Provider business mailing address

57 PROSPECT ST UNIT 1
NANTUCKET MA
02554-4396
US

V. Phone/Fax

Practice location:
  • Phone: 508-825-1000
  • Fax:
Mailing address:
  • Phone: 508-825-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN261984
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: