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MS. KELLEY MARIE ANDERSON LPN
NPI 1710437892
Licensed Practical Nurse in Brockport, NY

Active since October 12, 2016
500 WHITE ROAD, BROCKPORT, NY 14420(585) 944-4467 Get Directions Write a Review

NPPES record last updated: May 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2021, Oct 12, 2016 (2 updates tracked since 2016).

About Ms. Kelley Marie Anderson Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KELLEY MARIE ANDERSON LPN (NPI 1710437892) is an individual licensed practical nurse in Brockport, New York, licensed in New York (322767-1) and active in the NPI registry since October 2016.

NPPES Registry Identity

NPI1710437892
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMS. KELLEY MARIE ANDERSONCredential: LPN
Location Address500 WHITE ROADBrockport, NY 14420-9610
Mailing Address500 White RoadBrockport, NY 14420-9610 · (585) 944-4467
Phone(585) 944-4467
Sole ProprietorYes
Enumeration DateOctober 12, 2016
Last NPPES UpdateMay 19, 20212 updates tracked since enumeration
NPPES CertifiedMay 19, 2021
✔ NPI 1710437892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 322767-1
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
500 WHITE ROAD, Brockport, NY 14420
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Other Names 1

Former Name (1)Ms. Kelley Marie Glover Lpn

Other Identifiers 1

Medicaid04550001NY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelley Anderson's NPI number?

The NPI number for Kelley Anderson is 1710437892. It was assigned to this individual provider in the NPPES registry on October 12, 2016. The provider is also known as Ms. Kelley Marie Glover Lpn.

Where is Kelley Anderson located?

Kelley Anderson practices at 500 White Road, Brockport, NY 14420. The listed phone number is (585) 944-4467.

What is Kelley Anderson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kelley Anderson was last updated on May 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.