| Doctor Name: | KELLY LYNN DUSENBERY |
| NPI Number: | 1003248204 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | RN2269814 |
| Business Practice Address: | 137 W Central St Natick, MA - 017604310 |
| Business Phone Number: | 5086552109 |
| Business Fax Number: | |
| Mailing Address: | 199 Winthrop Rd, Apt 33 BROOKLINE |
| State: | MA |
| Postal Code: | 024454485 |
| Phone Number: | 5189299218 |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2013 |
| NPI Last Update Date: | 09/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN2269814 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |