Provider Demographics
NPI:1558644377
Name:TROMBLEY, KRISTY MARY (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:MARY
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 STATE ROUTE 22B
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-3417
Mailing Address - Country:US
Mailing Address - Phone:518-563-8000
Mailing Address - Fax:
Practice Address - Street 1:63 BROAD ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-3315
Practice Address - Country:US
Practice Address - Phone:518-563-8000
Practice Address - Fax:518-563-8261
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY576713163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult