Individual
DEBRA ELLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 PLEASANT AVE, SCHAGHTICOKE, NY 12154-3908
(518) 753-4458
(518) 753-7576
Mailing address
22 PLEASANT AVE, SCHAGHTICOKE, NY 12154-3908
(518) 753-4458
(518) 753-7576
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
318104-1
NY
163WS0200X
School Registered Nurse
Primary
318104-1
NY
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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