National Provider Identifier
Kelley Shannon Mistretta, MS, RN, ANP, C-EFM
Kelley Shannon Mistretta, MS, RN, ANP, C-EFM is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 862-1984.
Profile Overview
- NPI
- 1467874263
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- January 13, 2014
- Last Updated
- January 13, 2014
Practice Location
- 2157 Main St
- Buffalo, NY 14214-2648
Phone: (716) 862-1984
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1467874263
- Entity Type
- Individual
- Last Name
- Mistretta
- First Name
- Kelley
- Middle Name
- Shannon
- Name Prefix
- Mrs.
- Credential
- MS, RN, ANP, C-EFM
- Provider Other Last Name
- Ward
- Provider Other First Name
- Kelley
- Provider Other Middle Name
- Shannon
- Provider Other Credential Text
- MS, RN, ANP, C-EFM
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 2157 Main St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14214-2648
- Mailing Country
- US
- Mailing Phone
- (716) 862-1984
- Practice Street Address
- 2157 Main St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14214-2648
- Practice Country
- US
- Practice Phone
- (716) 862-1984
- Enumeration Date
- January 13, 2014
- Last Updated
- January 13, 2014
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X)