Healthcare Provider Details

I. General information

NPI: 1013823459
Provider Name (Legal Business Name): KELLY MAY TUPIA RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 MARGARET ST
PLATTSBURGH NY
12901-2968
US

IV. Provider business mailing address

24 KELSHAWN WAY
PLATTSBURGH NY
12901-4316
US

V. Phone/Fax

Practice location:
  • Phone: 518-565-4855
  • Fax: 518-565-4509
Mailing address:
  • Phone: 518-565-4855
  • Fax: 518-565-4509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number79747401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: