Individual
KELLY ANNE PRIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
99 E STATE ST, MAB-GPCC, GLOVERSVILLE, NY 12078-1203
(518) 773-5729
(518) 773-5620
Mailing address
99 E STATE ST, PO BOX 1250, GLOVERSVILLE, NY 12078-1203
(518) 773-5729
(518) 773-5620
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
F001126
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000404812003
BSH NE NY
NY
05
—
02459887
—
NY
01
—
6007701
MVP HEALTHPLAN
NY
Enumeration date
08/17/2006
Last updated
01/21/2015
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