National Provider Identifier

Kelley Maureen Stout, ANP

Kelley Maureen Stout, ANP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Penn Yan, NY and a listed phone number of (315) 729-0021.

NPI 1407048150Penn Yan, NYAdult Health Nurse Practitioner

Profile Overview

NPI
1407048150
Provider Type
Individual
Primary Specialty
Adult Health Nurse Practitioner
Enumeration Date
August 16, 2007
Last Updated
August 16, 2007

Practice Location

  • 166 South Ave
  • Penn Yan, NY 14527-1820

Phone: (315) 729-0021

Specialties

  • Adult Health Nurse Practitioner (363LA2200X)
Full Record
NPI
1407048150
Entity Type
Individual
Last Name
Stout
First Name
Kelley
Middle Name
Maureen
Credential
ANP
Provider Other Last Name
Barry
Provider Other First Name
Kelley
Provider Other Middle Name
Stout
Provider Other Last Name Type Code
1
Mailing Street Address
166 South Ave
Mailing City
Penn Yan
Mailing State
NY
Mailing ZIP Code
14527-1820
Mailing Country
US
Mailing Phone
(315) 729-0021
Mailing Fax
(315) 531-2268
Practice Street Address
166 South Ave
Practice City
Penn Yan
Practice State
NY
Practice ZIP Code
14527-1820
Practice Country
US
Practice Phone
(315) 729-0021
Practice Fax
(315) 531-2268
Enumeration Date
August 16, 2007
Last Updated
August 16, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Adult Health Nurse Practitioner (363LA2200X)
Other Identifiers
02049594 (NY)