Provider Demographics
NPI:1659777407
Name:MCARTHUR, KELLEY ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:ANN
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085
Mailing Address - Country:US
Mailing Address - Phone:413-562-8330
Mailing Address - Fax:413-562-3430
Practice Address - Street 1:325 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6341
Practice Address - Country:US
Practice Address - Phone:910-577-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014644363LF0000X
WV73990-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily