Individual
KELLY SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
86 BAKER AVENUE EXT STE 100, CONCORD, MA 01742-2132
(978) 369-1113
Mailing address
86 BAKER AVENUE EXT STE 100, CONCORD, MA 01742-2132
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2326293
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2326293
MA
Other
Enumeration date
06/12/2019
Last updated
05/25/2022
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