Provider Demographics
NPI:1649042631
Name:ONEILL, KALEY ELLEN (RN)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:ELLEN
Last Name:ONEILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2511
Mailing Address - Country:US
Mailing Address - Phone:978-604-6256
Mailing Address - Fax:
Practice Address - Street 1:30 BANCROFT AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2511
Practice Address - Country:US
Practice Address - Phone:978-604-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2355631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily