Individual
KEVIN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
163 LIBBEY PARKWAY, SUITE 301, WEYMOUTH, MA 02189-3118
(781) 337-4224
(781) 335-0429
Mailing address
163 LIBBEY PARKWAY, SUITE 301, WEYMOUTH, MA 02189-3118
(781) 337-4224
(781) 335-0429
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
166534
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
43888
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430051213
PALMETTO GBA
MA
Enumeration date
11/02/2006
Last updated
05/27/2008
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