Individual
KELLY MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-BC
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-2000
Mailing address
816 LORETTA DR, RIVER VALE, NJ 07675-6551
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ15087400
NJ
363LA2100X
Acute Care Nurse Practitioner
432802
NY
Other
Enumeration date
03/06/2024
Last updated
06/25/2024
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