Provider Demographics
NPI:1972149342
Name:FLAHERTY, KASEY (RN, BSN, MSN, FNP)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:RN, BSN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2644
Mailing Address - Country:US
Mailing Address - Phone:617-828-3245
Mailing Address - Fax:
Practice Address - Street 1:80 MARKET ST # 281
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-2602
Practice Address - Country:US
Practice Address - Phone:781-848-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2281714163WM0705X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical