Individual
KELLY DIRSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1000
Mailing address
62 WEBSTER AVE # 2, CAMBRIDGE, MA 02141-1934
(617) 913-4672
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2299279
MA
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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