Individual
KELLEY ELIZABETH THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN2301229
MA
2086S0120X
Pediatric Surgery Physician
RN2301229
MA
363L00000X
Nurse Practitioner
RN2301229
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2301229
MA
Other
Enumeration date
06/27/2022
Last updated
06/10/2025
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