Individual
DIANE M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
8 DENISON PKWY E, SUITE 201, CORNING, NY 14830-2638
(607) 936-4143
(607) 936-6836
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
335005
NY
363LF0000X
Family Nurse Practitioner
F335005
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02843209
—
NY
Enumeration date
11/06/2006
Last updated
06/13/2016
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