Individual
MS. KELLIANN BANAIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-AC
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
2346281
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN10006539
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2346281
MA
Other
Enumeration date
05/28/2026
Last updated
07/27/2026
Update your record
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