Basic Information
| Provider Information | |||||||||
| NPI: | 1639537467 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURRAY | ||||||||
| FirstName: | KELLEY | ||||||||
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| Credential: | CNP, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | LAHEY HOSPITAL & MEDICAL CENTER | ||||||||
| Address2: | 41 MALL ROAD | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018050001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817443839 | ||||||||
| FaxNumber: | 7817441597 | ||||||||
| Practice Location | |||||||||
| Address1: | LAHEY HOSPITAL & MEDICAL CENTER | ||||||||
| Address2: | 41 MALL ROAD | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018050001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817443839 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2016 | ||||||||
| LastUpdateDate: | 11/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN2298942 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LG0600X | 086356-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 163W00000X | RN2298942 | MA | N | Nursing Service Providers | Registered Nurse |
No ID Information.