Healthcare Provider Details

I. General information

NPI: 1942010491
Provider Name (Legal Business Name): KAYLEIGH LAUREN COMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NEWTON ST
SOUTHBOROUGH MA
01772-1215
US

IV. Provider business mailing address

11 CATHEDRAL LN
HUDSON NH
03051-5071
US

V. Phone/Fax

Practice location:
  • Phone: 508-481-5500
  • Fax:
Mailing address:
  • Phone: 603-321-5477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number085974-21
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN2369630
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF10241130
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: