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
| License | State | Type | Specialty |
|---|---|---|---|
| 318104-1 | NY | MD | School Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Schaghticoke, NY · School Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.