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General NPI Number Information
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NPI Number | 1366761363
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Entity Type | Individual
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Provider Name | KRISTEN KELLY M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 30 LOCUST ST CD PRACTICE ASSOCIATES, INC
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City | NORTHAMPTON
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State | MA
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Zip | 01060-2052
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Country | US
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Telephone | 413-582-2898
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Fax |
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Provider Business Mailing Address
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Address Line | 30 LOCUST ST WOMEN'S HEALTH CARE OF COOLEY DICKINSON
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City | NORTHAMPTON
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State | MA
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Zip | 01060-2052
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Country | US
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Telephone | 413-582-2879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 244752
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License Number State | MA
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