Individual
MARY LOU MCKELVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2350 ROUTE 63, WAYLAND, NY 14572-9509
(585) 728-2091
(585) 728-5658
Mailing address
2350 ROUTE 63, WAYLAND, NY 14572-9509
(585) 728-2091
(585) 728-5658
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
223305221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166002121
—
NY
Enumeration date
12/15/2011
Last updated
12/15/2011
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