Provider Demographics
NPI:1639539083
Name:KELLEY, MICHELE LYNN (CNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYNN
Last Name:KELLEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:ONE BROOKLINE PLACE
Mailing Address - Street 2:ARNOLD WARFIELD PAIN CENTER, STE 105
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-1629
Mailing Address - Country:US
Mailing Address - Phone:617-278-8000
Mailing Address - Fax:617-278-8040
Practice Address - Street 1:ONE BROOKLINE PLACE
Practice Address - Street 2:ARNOLD WARFIELD PAIN CENTER, STE 105
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-1629
Practice Address - Country:US
Practice Address - Phone:617-278-8000
Practice Address - Fax:617-278-8040
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-28
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266042363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner