Individual provider · Type 1 NPI
Noelle Catherine Kellicker, CNP
Pediatric Nurse Practitioner · Worcester, MA
NPI number
1245769074
Active
Practice location
55 Lake Ave N
Worcester, MA 01655-0002
Fax (774) 443-7268
Mailing address
PO Box 415348
Boston, MA 02241-5348
Other practice locations
- 26 Queen Street, Credentialing Dept./medical Services, Worcester, MA 01610-2473 · (508) 860-7800
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RN2315082 (MA) |
| Nurse Practitioner | 363L00000X | RN2315082 (MA) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | RN2315082 (MA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1245769074
Noelle Catherine Kellicker, CNP's National Provider Identifier is 1245769074, issued on Jun 6, 2017. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Worcester, MA. The record was last updated on Jul 21, 2022.