Individual
KELLIE CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 ESSEX CENTER DR STE 1, PEABODY, MA 01960-2930
(978) 977-4000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8597
MA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/01/2022
Last updated
02/23/2024
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