Individual
KELLY HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
632 BLUE HILL AVE, DORCHESTER, MA 02121-3213
(617) 825-3400
Mailing address
5 STOCK ST APT 2, DORCHESTER, MA 02122-2672
(617) 943-1169
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN2341139
MA
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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