Healthcare Provider Details

I. General information

NPI: 1760720536
Provider Name (Legal Business Name): NITA TOUPIN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S PERRY ST
WATKINS GLEN NY
14891-1636
US

IV. Provider business mailing address

1615 SWITZER HILL RD
BEAVER DAMS NY
14812-9732
US

V. Phone/Fax

Practice location:
  • Phone: 570-535-8282
  • Fax: 607-535-8284
Mailing address:
  • Phone: 607-684-0110
  • Fax: 607-306-4839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF402979-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN524956L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: