Individual
KELLY ANN YALE-SUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, GRADUATE NP
Contact information
Practice address
30 HARRISON ST STE 355, JOHNSON CITY, NY 13790-2162
(607) 763-8102
(607) 763-8018
Mailing address
169 RIVERSIDE DR, BINGHAMTON, NY 13905-4246
(607) 352-3550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
587887
NY
363L00000X
Nurse Practitioner
309912
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
309912
NY
Other
Enumeration date
05/08/2020
Last updated
11/18/2025
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