Provider Demographics
NPI:1477864452
Name:NEDBALSKI, KATHLEEN ADAMS (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ADAMS
Last Name:NEDBALSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 BORNT HILL RD
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-6537
Mailing Address - Country:US
Mailing Address - Phone:607-754-5849
Mailing Address - Fax:
Practice Address - Street 1:999 TAFT AVE
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-7205
Practice Address - Country:US
Practice Address - Phone:607-757-2148
Practice Address - Fax:607-757-2546
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302680-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool