Individual
CARLY J MCKILLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
169 RIVERSIDE DR, LOURDES PRIMARY CARE NETWORK, SUITE 307, BINGHAMTON, NY 13905-4246
(607) 798-5897
(607) 798-5093
Mailing address
169 RIVERSIDE DR, LOURDES PRIMARY CARE NETWORK, SUITE 307, BINGHAMTON, NY 13905-4246
(607) 798-5897
(607) 798-5093
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
338053
NY
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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