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Individual

MARY ELLEN HANNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1 ALTON RD, ALBANY, NY 12203-4201
(518) 456-0428
(518) 456-0471
Mailing address
10 EILEEN ST, ALBANY, NY 12203-2102
(518) 438-3685

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
380781
NY

Other

Enumeration date
09/22/2006
Last updated
07/08/2007
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