Kelley, Lisa M

Kelley, Lisa M is an individual health care provider with primary practice located at 93 Barker Rd , Central Square NY 13036-3460. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Kelley, Lisa M can be contacted via phone (315) 668-4253.

Contact Information

Primary practice address
93 Barker Rd Central Square NY 13036-3460
Phone: (315) 668-4253
Fax: (315) 668-4299
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X 51338-1 New York

Profile Details

NPI number 1447504634
LBN Legal business name Kelley, Lisa M
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2012
Last updated Nov 9th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447504634 NPPES
New York MEDICAID 51338-1

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