Individual
MRS. STACIE L COLLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
366 COUNTY ROUTE 17, BRUSHTON, NY 12916-4403
(518) 529-7243
Mailing address
366 COUNTY ROUTE 17, BRUSHTON, NY 12916-4403
(518) 529-7243
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
579751
NY
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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