Mary K Kelly, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

012404-22 Issued in NH

Practice address

94 Bridge St
Hillsboro, NH 03244

Phone

(160) 349-3184

NPI assigned

May 11, 2022

Last updated

May 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mary K Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1417693409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1696",
            "city": "HILLSBORO",
            "state": "NH",
            "postal_code": "032441696",
            "telephone_number": "160-349-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 BRIDGE ST",
            "city": "HILLSBORO",
            "state": "NH",
            "postal_code": "03244",
            "telephone_number": "160-349-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NH",
            "license": "012404-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KELLY",
            "middle_name": "K",
            "credential": "HEFFERNAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Deborah A Lee, D.C.
• Courtney Leitner

• Licensed Practical Nurse in Hillsboro, NH
• Providers in Hillsboro, NH by specialty
• Licensed Practical Nurse in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.