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Individual

MRS. KIM M PREMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
524 EAST MAIN STREET, FLANDERS ELEMENTARY SCHOOL, MALONE, NY 12953
(518) 483-7803
(518) 483-9491
Mailing address
524 EAST MAIN STREET, FLANDERS ELEMENTARY SCHOOL, MALANE, NY 12953
(518) 483-7803
(518) 483-9491

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
381242-1
NY

Other

Enumeration date
04/16/2012
Last updated
04/16/2012
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