Individual
KIM MARIE KELCHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
103 N MAIN ST, CORTLAND, NY 13045-1207
(607) 758-9977
(607) 758-9907
Mailing address
103 N MAIN ST, CORTLAND, NY 13045-1207
(607) 758-9977
(607) 758-9907
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
336063
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03423030
—
NY
Enumeration date
10/09/2009
Last updated
03/10/2014
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