Individual
KIA L MCHOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
89 CARSON AVE, NEWBURGH, NY 12550-5920
(845) 568-5645
(845) 568-5645
Mailing address
89 CARSON AVE, NEWBURGH, NY 12550-5920
(845) 568-5645
(845) 568-5645
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
284267-1
NY
164X00000X
Licensed Vocational Nurse
Primary
284267-1
NY
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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