| Doctor Name: | MS. KELLY ELISHA TRECARTIN |
| NPI Number: | 1003130469 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | RN214741 |
| Business Practice Address: | 55 Fruit St Bigalow 852 F Boston, MA - 021142621 |
| Business Phone Number: | 6177267400 |
| Business Fax Number: | 6177264149 |
| Mailing Address: | 55 Fruit St, Bigalow 852 F BOSTON |
| State: | MA |
| Postal Code: | 021142621 |
| Phone Number: | 6177267400 |
| Fax Number: | 6177264149 |
| NPI Enumeration Date: | 03/15/2010 |
| NPI Last Update Date: | 03/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | RN214741 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |