Individual
NOELLE CATHERINE KELLICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-2853
(774) 443-7268
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN2315082
MA
363L00000X
Nurse Practitioner
RN2315082
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2315082
MA
Other
Enumeration date
06/06/2017
Last updated
07/21/2022
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