Shelly Marie Champlin, LPN
Individual provider Active NPI Licensed Practical Nurse · Bainbridge, NY
NPI 1649543307 · NPPES record last updated Feb 10, 2012
Key facts
- NPI
- 1649543307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 10283001 (NY)
- Practice address
- 46 Kirby St
Bainbridge, NY 13733-1147 - Phone
- (607) 967-4337
- NPI assigned
- Feb 10, 2012
- 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 |
|---|---|---|---|
| 10283001 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 10283001 | NY | Yes |
Addresses
Primary practice location
46 Kirby St
Bainbridge, NY 13733-1147
Mailing address
46 Kirby St
Bainbridge, NY 13733-1147
Phone (607) 967-4337
Other providers in Bainbridge, NY
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- Robert P Blitz
- Khalid Rashid Butt
- Michelle Marie Castle
- Kelly Anne Cirigliano
- Doddy Lee Crisell
- David Bame Jr
- Julie Ann Davy
- Rachel Lauren Decker
All providers in Bainbridge, NY · Licensed Practical 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 Feb 10, 2012. 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.