Kelly, Diane M

Kelly, Diane M is an individual health care provider with primary practice located at 8 Denison Pkwy E Suite 201, Corning NY 14830-2638. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kelly, Diane M can be contacted via phone (607) 936-4143.

Contact Information

Primary practice address
8 Denison Pkwy E Suite 201 Corning NY 14830-2638
Phone: (607) 936-4143
Fax: (607) 936-6836
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F335005 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 335005 New York

Profile Details

NPI number 1083783278
LBN Legal business name Kelly, Diane M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Jun 13th, 2016 - about 9 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 1083783278 NPPES
New York MEDICAID 02843209

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