Individual
MRS. KELLEY SHANNON MISTRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RN, ANP, C-EFM
Contact information
Practice address
2157 MAIN ST, BUFFALO, NY 14214-2648
(716) 862-1984
Mailing address
2157 MAIN ST, BUFFALO, NY 14214-2648
(716) 862-1984
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306653-1
NY
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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