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NPI Code Detail

MEDICARE: NATHAN HALE PHELPS NP

MEDICARE: NATHAN HALE PHELPS NP
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
1363LF0000XFamily Nurse Practitioner358710NY

General Provider Information

NPI Number : 1497622617
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN HALE PHELPS NP
Provider Business Mailing Address
First Line : PO BOX 14890
Second Line :
City : ALBANY
State : NY
Zip : 12212-4890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11 HAMPSTEAD PLACE SUITE 103
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-5669
Country : US
Telephone Number : 518-583-7400
Fax Number : 518-583-4184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2025
Last Update Date : 03/02/2026

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Directions to “ NATHAN HALE PHELPS NP” Practice Location

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