Individual provider · Type 1 NPI

Siobhan Elizabeth Kelly

Nurse Practitioner · Boston, MA

NPI number 1679349211 Active

Practice location

55 Fruit Street
Boston, MA 02241-9095

Mailing address

128 Bunker Hill St
Charlestown, MA 02129-3128

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XRN2340465 (MA)
General Practice Registered Nurse 163WG0000XRN2340465 (MA)
Administrator Registered Nurse 163WA2000XRN2340465 (MA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1679349211

Siobhan Elizabeth Kelly's National Provider Identifier is 1679349211, issued on Nov 27, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Boston, MA. The record was last updated on Feb 25, 2026.