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Individual

KADIAN RENNYA KELLY-KNIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
217 LINCOLN ST, WINTHROP, MA 02152-3012
(617) 846-7676
Mailing address
42 WOODROW AVE, DORCHESTER, MA 02124-3238
(617) 297-6908

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN92561
MA

Other

Enumeration date
11/27/2017
Last updated
11/27/2017
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