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General NPI Number Information
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NPI Number | 1497899595
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Entity Type | Individual
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Provider Name | MICHELLE KIRLEY NP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | EVERCARE 950 WINTER STREET, SUITE 3800
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City | WALTHAM
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State | MA
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Zip | 02451
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Country | US
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Telephone | 781-472-8534
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Fax | 781-472-8801
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Provider Business Mailing Address
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Address Line | 532 GROVE ST
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City | WORCESTER
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State | MA
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Zip | 01605-1241
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Country | US
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Telephone | 781-472-8534
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Fax | 781-472-8801
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 141285NP
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License Number State | MA
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