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General NPI Number Information
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NPI Number | 1871310029
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Entity Type | Organization
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Legal Business Name | KINDRED WELLNESS CARE NP IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 09/20/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 7 STEVENS ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-3458
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Country | US
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Telephone | 518-321-4970
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Fax | 518-240-4977
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Provider Business Mailing Address
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Address Line | 7 STEVENS ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-3458
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Country | US
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Telephone | 518-321-4970
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Fax | 518-240-4977
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Authorized Official
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Title or Position | MANAGER
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Name | SHANNON JAMES
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Credential | NP
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Telephone | 518-321-4970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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