Individual
COLETTE STAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4433 VESTAL PKWY E, VESTAL, NY 13850
(607) 240-2879
(607) 240-2972
Mailing address
33 LEWIS RD, 2ND FL, BINGHAMTON, NY 13905
(607) 729-8156
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
688402
NY
363LF0000X
Family Nurse Practitioner
Primary
343553
NY
Other
Enumeration date
08/13/2018
Last updated
01/09/2025
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