Individual
MICHAEL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
202 ASHLAND ST, HOLLISTON, MA 01746-1227
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN274303
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN274303
MA
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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