Shelly A Clancy, RN
Individual provider Active NPI Registered Nurse · Hornell, NY
NPI 1487922480 · NPPES record last updated Dec 5, 2011
Key facts
- NPI
- 1487922480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 429405-1 (NY)
- Practice address
- 134 Seneca St
Hornell, NY 14843-1324 - Phone
- (607) 324-3710
- Fax
- (607) 324-3710
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 429405-1 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 429405-1 | NY | Yes |
Addresses
Primary practice location
134 Seneca St
Hornell, NY 14843-1324
Mailing address
422 Seneca Rd
Hornell, NY 14843-1017
Phone (607) 324-3710
Other providers in Hornell, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 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.