Organization
LIFESPAN NP PSYCHIATRIC SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY DORMAN NP (OWNER, PRESIDENT)
(315) 200-9723
Entity
Organization
Contact information
Practice address
60 E STATE ST STE 400, SHERRILL, NY 13461-1218
(315) 200-9723
Mailing address
1021 CHAPEL ST, ONEIDA, NY 13421-2837
(315) 200-9723
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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