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General NPI Number Information
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NPI Number | 1710618806
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Entity Type | Individual
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Provider Name | KEELY O'MARA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 1 BROOKLINE PL
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City | BROOKLINE
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State | MA
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Zip | 02445-7224
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Country | US
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Telephone | 617-732-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 48 DOVER TER
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City | WESTWOOD
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State | MA
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Zip | 02090-2415
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Country | US
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Telephone | 518-605-0521
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN2329916
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 735115
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | RN2329916
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License Number State | MA
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