Basic Information
| Provider Information | |||||||||
| NPI: | 1437271566 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KELLIHER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 771 ALBANY ST | ||||||||
| Address2: | DOWLING 1 SOUTH | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174145481 | ||||||||
| FaxNumber: | 6174147759 | ||||||||
| Practice Location | |||||||||
| Address1: | 771 ALBANY ST | ||||||||
| Address2: | DOWLING 1 SOUTH | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174145481 | ||||||||
| FaxNumber: | 6174147759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 184567 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.