Healthcare Provider Details

I. General information

NPI: 1386709608
Provider Name (Legal Business Name): HILLARY ANNE KELLY-STEPHENS MS, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HILLARY ANNE KELLY MS FNPC

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 E STATE ST
HERKIMER NY
13350
US

IV. Provider business mailing address

207 STROUD ST 338 E STATE STREET HERKIMER NY 13350
CANASTOTA NY
13032
US

V. Phone/Fax

Practice location:
  • Phone: 315-619-9700
  • Fax: 315-619-9701
Mailing address:
  • Phone: 315-619-9700
  • Fax: 315-619-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF402440
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF334926
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334926
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: