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
Fax: (617) 730-0495

Health care specialties

SpecialtyCodeLicense #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.

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All States NPI 1245221464 NPPES
Massachusetts Other NP9723 BCBS
Massachusetts MEDICAID 0321851 BCBS

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