Individual
MRS. FAWN SHELLEY MUMBULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1394
(607) 547-3480
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1394
(607) 547-3480
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F338835-1
NY
Other
Enumeration date
06/26/2014
Last updated
04/03/2026
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