Provider Demographics
NPI:1235412040
Name:KELLY, LINDSEY RAE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:RAE
Last Name:KELLY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5 MARION ST
Mailing Address - Street 2:APT 1
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2103
Mailing Address - Country:US
Mailing Address - Phone:617-665-3600
Mailing Address - Fax:617-665-3603
Practice Address - Street 1:119 WINDSOR ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3647
Practice Address - Country:US
Practice Address - Phone:617-636-5000
Practice Address - Fax:617-665-3603
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2016-11-06
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Provider Licenses
StateLicense IDTaxonomies
MAPA4268363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant