Provider Demographics
NPI:1689652174
Name:STORMANN, NITA J (NP)
Entity Type:Individual
Prefix:
First Name:NITA
Middle Name:J
Last Name:STORMANN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:17 MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-6606
Mailing Address - Country:US
Mailing Address - Phone:607-753-3797
Mailing Address - Fax:607-753-6677
Practice Address - Street 1:23 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:MORAVIA
Practice Address - State:NY
Practice Address - Zip Code:13118-3427
Practice Address - Country:US
Practice Address - Phone:315-497-9066
Practice Address - Fax:315-497-4156
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-11-30
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Provider Licenses
StateLicense IDTaxonomies
NY331660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB8326Medicare PIN