Individual
SHANNON KILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(201) 270-6601
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(201) 270-6601
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F311028-01
NY
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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