Individual
MS. SHANNON BLUME-KESSELRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
86 GENESEE STREET, NEW HARTFORD, NY 13413
(315) 732-7909
(315) 793-9307
Mailing address
86 GENESEE STREET, NEW HARTFORD, NY 13413
(315) 732-7909
(315) 793-9307
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
4918541
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F333382
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02254557
—
NY
05
—
02873201
—
NY
05
—
02996981
—
NY
Enumeration date
08/01/2006
Last updated
11/02/2023
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