Healthcare Provider Details

I. General information

NPI: 1982852182
Provider Name (Legal Business Name): SALLLY A SPRINGSTEAD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 08/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 E STATE ST
GLOVERSVILLE NY
12078-1204
US

IV. Provider business mailing address

127 E STATE ST
GLOVERSVILLE NY
12078-1204
US

V. Phone/Fax

Practice location:
  • Phone: 518-725-9961
  • Fax: 518-773-7505
Mailing address:
  • Phone: 518-725-9961
  • Fax: 518-773-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number465963
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: