Individual
KELLY CHANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
67 BAKER AVE, BEVERLY, MA 01915-3539
(508) 783-5183
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2267035
MA
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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