Healthcare Provider Details

I. General information

NPI: 1942022553
Provider Name (Legal Business Name): KATELYN PATRICIA KEYS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 MAIN ST STE 3B
NORTH READING MA
01864-2286
US

IV. Provider business mailing address

21 MAIN ST STE 3B
NORTH READING MA
01864-2286
US

V. Phone/Fax

Practice location:
  • Phone: 978-664-5979
  • Fax:
Mailing address:
  • Phone: 978-664-5979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2303476
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: