National Provider Identifier
Etta L Storm, NP IN PEDIATRICS
Etta L Storm, NP IN PEDIATRICS is listed in the NPPES registry with a primary specialty of Pediatric Nurse Practitioner in Orchard Park, NY and a listed phone number of (716) 674-1292.
Profile Overview
- NPI
- 1487762258
- Provider Type
- Individual
- Primary Specialty
- Pediatric Nurse Practitioner
- Enumeration Date
- August 29, 2006
- Last Updated
- July 08, 2007
Practice Location
- 3085 Southwestern Blvd
- Suite 104
- Orchard Park, NY 14127-1233
Phone: (716) 674-1292
Specialties
- Pediatric Nurse Practitioner (363LP0200X)
Full Record
- NPI
- 1487762258
- Entity Type
- Individual
- Last Name
- Storm
- First Name
- Etta
- Middle Name
- L
- Credential
- NP IN PEDIATRICS
- Mailing Street Address
- 3085 Southwestern Blvd
- Mailing Address Line 2
- Suite 104
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-1233
- Mailing Country
- US
- Mailing Phone
- (716) 674-1292
- Mailing Fax
- (716) 677-4314
- Practice Street Address
- 3085 Southwestern Blvd
- Practice Address Line 2
- Suite 104
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-1233
- Practice Country
- US
- Practice Phone
- (716) 674-1292
- Practice Fax
- (716) 677-4314
- Enumeration Date
- August 29, 2006
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Nurse Practitioner (363LP0200X)
- Other Identifiers
- 9511811 (Independent Health), 00026500201 (Univera Healthcare), 000560930001 (BCBS Of Western New York)