Provider Demographics
NPI:1528307816
Name:KELLY, KATHERINE E (FNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:E
Last Name:KELLY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:193 LOCUST ST
Mailing Address - Street 2:STE. 2
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2056
Mailing Address - Country:US
Mailing Address - Phone:413-584-8700
Mailing Address - Fax:413-584-1714
Practice Address - Street 1:193 LOCUST ST
Practice Address - Street 2:STE. 2
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2056
Practice Address - Country:US
Practice Address - Phone:413-584-8700
Practice Address - Fax:413-584-1714
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2272279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily