Provider Demographics
NPI:1225792229
Name:STRICKLAND, KELLY MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:MARIE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KELLY
Other - Middle Name:MARIE
Other - Last Name:QUARANTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10175 NIAGARA FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2941
Mailing Address - Country:US
Mailing Address - Phone:716-205-0170
Mailing Address - Fax:
Practice Address - Street 1:10175 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-2941
Practice Address - Country:US
Practice Address - Phone:716-205-0170
Practice Address - Fax:716-205-0818
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY824463163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse