Provider Demographics
NPI:1861863540
Name:HORIGAN, KELLY MAUREEN (RN CRNA)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:MAUREEN
Last Name:HORIGAN
Suffix:
Gender:F
Credentials:RN CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 SHREWSBURY AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 SHREWSBURY AVE STE 308
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4151
Practice Address - Country:US
Practice Address - Phone:732-450-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN621329163W00000X
NY639354163W00000X
NJ26NR22134300163W00000X
NJ26NJ14997200367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse