Individual
AMANDA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2794
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2264012
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1460
—
SC
Enumeration date
08/29/2006
Last updated
04/02/2019
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