Individual
LISA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN2329969
MA
Other
Enumeration date
03/13/2019
Last updated
07/08/2022
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