Provider Demographics
NPI:1285284026
Name:KEARNEY, TAYLOR SHEA (FNP-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:SHEA
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-0061
Mailing Address - Country:US
Mailing Address - Phone:978-895-0361
Mailing Address - Fax:
Practice Address - Street 1:115 LYMAN RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MA
Practice Address - Zip Code:01503-1802
Practice Address - Country:US
Practice Address - Phone:978-895-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program