Shelley Vankempen

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Warrensburg, NY

NPI 1780692152 · NPPES record last updated Jul 31, 2008

Key facts

NPI
1780692152
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
400541 (NY)
Practice address
3767 Main St
Warrensburg, NY 12885-1837
Phone
(518) 623-2844
Fax
(518) 623-3416
NPI assigned
Aug 3, 2006
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)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 400541 NY Yes

Addresses

Primary practice location

3767 Main St
Warrensburg, NY 12885-1837

Mailing address

1 Broad Street PLZ
PO Box 357
Glens Falls, NY 12801-4390
Phone (518) 761-0300

Other identifiers

IdentifierTypeStateIssuer
00630039MedicaidNY

Other providers in Warrensburg, NY

All providers in Warrensburg, NY · Psychiatric/Mental Health Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.