Provider Demographics
NPI:1962543793
Name:KELLOGG, PATRICIA M (NP)
Entity type:Individual
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First Name:PATRICIA
Middle Name:M
Last Name:KELLOGG
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Gender:F
Credentials:NP
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Mailing Address - Street 1:24 MORRILL PL STE 2
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3530
Mailing Address - Country:US
Mailing Address - Phone:978-834-8074
Mailing Address - Fax:978-834-8077
Practice Address - Street 1:600 PRIMROSE ST STE 202
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-2659
Practice Address - Country:US
Practice Address - Phone:978-556-1000
Practice Address - Fax:978-556-0101
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2021-06-09
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Provider Licenses
StateLicense IDTaxonomies
MA163778363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30342198Medicaid
MA0391930Medicaid
MA0391930Medicaid