Dr. Jessica Kelly Creedon
Pediatrician Pediatric Emergency Doctor
300 Longwood Ave
Boston
, Massachusetts 02115-5724
Dr. Jessica Kelly Creedon
Pediatrician Pediatric Emergency Doctor
300 Longwood Ave
Boston
, Massachusetts 02115-5724
(617) 355-6000
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About
Features
Specialties
- Pediatrician
- Pediatric Emergency Doctor
Languages spoken
- English
Location
First Address
- Dr. Jessica Kelly Creedon
- 300 Longwood Ave
- Boston, MA
- Zip : 02115-5724
- Phone : (617) 355-6000
Second Address
- Dr. Jessica Kelly Creedon
- 300 Longwood Ave
- Boston, MA
- Zip : 02115-5724
- Phone : (617) 355-6000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 257923 | MA |
| Y | 2080P0204X | Pediatric Emergency Doctor | 257923 | MA |
National Provider Identifier
| NPI | 1306145172 |
|---|---|
| Provider Name | Dr. Jessica Kelly Creedon |
| First Address | Boston, MA 02115-5724 |
| Second Address | Boston, MA 02115-5724 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/03/2011 |
| Last Update Date | 31/12/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.