Individual
KELLIE L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
118 FREEVILLE RD, DRYDEN, NY 13053-9625
(607) 844-8694
Mailing address
209 BRADSHAW RD, DRYDEN, NY 13053-9579
(607) 423-5960
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
751503
NY
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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