Individual
MS. KIMBERLI A OMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6058
(617) 730-0495
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6058
(617) 730-0495
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
236043
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321851
—
MA
01
—
NP9723
BCBS
MA
Enumeration date
11/04/2005
Last updated
10/06/2009
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