Individual
HAIDANG TRUONG KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
147 MILK ST FL 3, BOSTON, MA 02109
(617) 654-7280
(617) 654-7363
Mailing address
147 MILK ST FL 9, BOSTON, MA 02109-4806
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN2263216
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110022129
—
MA
Enumeration date
09/26/2013
Last updated
07/17/2018
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