Individual
MRS. KELLEY ANN PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
175 CONNORS STREET, GARDNER, MA 01440
(978) 410-6121
(978) 410-6109
Mailing address
326 NICHOLS ROAD, FITCHBURG, MA 01420
(978) 878-8100
(978) 878-8537
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AP2003
MA
Other
Enumeration date
01/26/2006
Last updated
10/28/2015
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