KELLEY MAUREEN STOUT ANP
NPI 1407048150
Nurse Practitioner - Adult Health in Penn Yan, NY
Active since August 16, 2007
About Kelley Maureen Stout Anp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEY MAUREEN STOUT ANP (NPI 1407048150) is an individual adult health provider in Penn Yan, New York, licensed in New York (F30-302516) and active in the NPI registry since August 2007.
NPPES Registry Identity
NPI1407048150
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameKELLEY MAUREEN STOUTCredential: ANP
Location Address166 SOUTH AVEPenn Yan, NY 14527-1820
Mailing Address166 South AvePenn Yan, NY 14527-1820 · (315) 729-0021 · Fax (315) 531-2268
Phone(315) 729-0021
Fax(315) 531-2268
Sole ProprietorYes
Enumeration DateAugust 16, 2007
✔ NPI 1407048150 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · F30-302516
166 SOUTH AVE, Penn Yan, NY 14527
Other Names 1
Former Name (1)Kelley Stout Barry
Other Identifiers 2
Medicaid02049594NY
Medicare UPINCC4047NY
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407048150, enumerated as an "individual" on August 16, 2007.
The provider is located at 166 SOUTH AVE PENN YAN, NY 14527 and the phone number is (315) 729-0021.
Nurse Practitioner with taxonomy code 363LA2200X and a focus in Adult Health.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
