Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | RN2280776 | MA |
NPI | 1093164345 |
---|---|
Provider Name | Melissa Kelly Forbes |
First Address | Boston, MA 02114-1105 |
Second Address | Boston, MA 02114-1105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 12/10/2021 |