Individual
MRS. JENNIFER LYN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7 MICHELLE LEE DR, BERKLEY, MA 02779-2224
(508) 822-1711
Mailing address
7 MICHELLE LEE DR, BERKLEY, MA 02779-2224
(508) 822-1711
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
225835
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0707805
MA HEALTH PROVIDER
MA
Enumeration date
05/04/2007
Last updated
07/08/2007
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