Debra Ellett

Individual provider Active NPI School Registered Nurse · Schaghticoke, NY

NPI 1043594096 · NPPES record last updated Oct 7, 2011

Key facts

NPI
1043594096
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
318104-1 (NY)
Practice address
22 Pleasant Ave
Schaghticoke, NY 12154-3908
Phone
(518) 753-4458
Fax
(518) 753-7576
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
318104-1NYMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 318104-1 NY
School Registered Nurse 163WS0200X 318104-1 NY Yes

Addresses

Primary practice location

22 Pleasant Ave
Schaghticoke, NY 12154-3908

Mailing address

22 Pleasant Ave
Schaghticoke, NY 12154-3908
Phone (518) 753-4458

Other providers in Schaghticoke, NY

All providers in Schaghticoke, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.