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General NPI Number Information
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NPI Number | 1740678358
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Entity Type | Individual
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Provider Name | BREANA KELLY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 2 MEETING HOUSE RD
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City | CHELMSFORD
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State | MA
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Zip | 01824-2878
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Country | US
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Telephone | 978-256-5522
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Fax | 978-256-5399
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Provider Business Mailing Address
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Address Line | 256 HAVEN ST
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City | READING
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State | MA
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Zip | 01867-3216
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Country | US
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Telephone | 978-771-3073
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06141081
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License Number State | MA
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