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NPI Code Detail

MEDICARE: KELLI LYNN PATE LPN

MEDICARE: KELLI LYNN PATE LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse338888NY

General Provider Information

NPI Number : 1336922913
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI LYNN PATE LPN
Provider Business Mailing Address
First Line : 3344 CHAMBERS RD STE 100
Second Line :
City : HORSEHEADS
State : NY
Zip : 14845-1403
Country : US
Telephone Number : 607-734-2264
Fax Number : 607-796-5849
Provider Business Practice Location Address
First Line : 3344 CHAMBERS RD STE 100
Second Line :
City : HORSEHEADS
State : NY
Zip : 14845-1403
Country : US
Telephone Number : 607-973-8576
Fax Number : 607-796-5849
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2023
Last Update Date : 08/16/2023

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Directions to “ KELLI LYNN PATE LPN” Practice Location

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