Healthcare Provider Details

I. General information

NPI: 1275976995
Provider Name (Legal Business Name): CYNTHIA A KELLEY-GRADY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HIGH ST STE 300
SPRINGFIELD MA
01105-1435
US

IV. Provider business mailing address

25 BOND ST
SPRINGFIELD MA
01104-3401
US

V. Phone/Fax

Practice location:
  • Phone: 413-887-5130
  • Fax: 413-733-1924
Mailing address:
  • Phone: 134-949-5849
  • Fax: 508-425-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2263526
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: