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General NPI Number Information
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NPI Number | 1487628566
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Entity Type | Individual
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Provider Name | KELLY L HARGETT PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 1385 LAKEVIEW AVENUE
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City | DRACUT
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State | MA
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Zip | 01826-3414
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Country | US
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Telephone | 978-545-1442
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Fax | 978-545-1552
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Provider Business Mailing Address
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Address Line | 18 SINGLEFOOT RD
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City | CHELMSFORD
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State | MA
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Zip | 01824-1926
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Country | US
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Telephone | 978-545-1442
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Fax | 978-545-1552
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 258985
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 258985
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License Number State | MA
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