Individual
SHELLY L HOLLENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21 N 2ND ST, FULTON, NY 13069-1250
(315) 598-7105
(315) 598-4857
Mailing address
21 N 2ND ST, FULTON, NY 13069-1250
(315) 598-7105
(315) 598-4857
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F306927
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
ALL ARE PENDING
NY
Enumeration date
01/13/2015
Last updated
01/13/2015
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