Individual
BRITTANY SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1355 OLEAN PORTVILLE ROAD, WESTON MILLS, NY 14788
(716) 373-0021
Mailing address
528 1/2 1ST AVE, OLEAN, NY 14760-1704
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
673808-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-1039939
OTHER INSURNACES
NY
05
—
161039939
—
NY
Enumeration date
10/01/2024
Last updated
10/01/2024
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