Provider Demographics
NPI:1659521714
Name:KELLEY, MARGARET JULIA (MSN, APRN-CNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JULIA
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MSN, APRN-CNP
Other - Prefix:MS
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANP
Mailing Address - Street 1:10 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-1602
Mailing Address - Country:US
Mailing Address - Phone:207-721-9277
Mailing Address - Fax:207-729-1368
Practice Address - Street 1:66 BARIBEAU DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3230
Practice Address - Country:US
Practice Address - Phone:207-721-9277
Practice Address - Fax:207-729-1368
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81084363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health