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Individual

ELIZABETH J KELTERBORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
135 N UNION ST, OLEAN, NY 14760-2736
(176) 375-7500
(716) 806-1287
Mailing address
834 NORTH UNION STREET, OLEAN, NY 14760
(347) 891-1304

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3009698
KY
363L00000X
Nurse Practitioner
Primary
F341652
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04757282
NY
05
7100383990
KY
01
J40038433
MEDICARE
NY
01
P01571407
RAILROAD MEDICARE (KOHMG)
KY
Enumeration date
09/21/2015
Last updated
07/21/2022
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