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General NPI Number Information
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NPI Number | 1548895428
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Entity Type | Individual
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Provider Name | KELLY LEE DROLLETTE NP
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 3384 STATE ROUTE 22 STE 3
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City | PERU
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State | NY
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Zip | 12972-5305
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Country | US
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Telephone | 518-643-8008
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Fax | 518-643-8090
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Provider Business Mailing Address
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Address Line | 4400 VESTAL PKWY E
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City | BINGHAMTON
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State | NY
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Zip | 13902-4601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F347881
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 347881
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License Number State | NY
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