Omalley, Kimberli A
Omalley, Kimberli A is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Omalley, Kimberli A can be contacted via phone (617) 355-6058.Contact Information
Primary practice address
300 Longwood Ave
Boston MA 02115-5724
Phone: (617) 355-6058
Fax: (617) 730-0495
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 236043 | Massachusetts |
Profile Details
| NPI number | 1245221464 |
|---|---|
| LBN Legal business name | Omalley, Kimberli A |
| Credentials | Pediatric Nurse Practitioner (PNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Oct 6th, 2009 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245221464 | NPPES |
| Massachusetts | Other | NP9723 | BCBS |
| Massachusetts | MEDICAID | 0321851 | BCBS |
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