Provider Demographics
NPI:1871310029
Name:KINDRED WELLNESS CARE NP IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:KINDRED WELLNESS CARE NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:518-321-4970
Mailing Address - Street 1:7 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3458
Mailing Address - Country:US
Mailing Address - Phone:518-321-4970
Mailing Address - Fax:518-240-4977
Practice Address - Street 1:7 STEVENS ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3458
Practice Address - Country:US
Practice Address - Phone:518-321-4970
Practice Address - Fax:518-240-4977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty