Provider Demographics
NPI:1013902048
Name:KELCHLIN, ANN B (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:B
Last Name:KELCHLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:132 MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-3603
Mailing Address - Country:US
Mailing Address - Phone:518-234-8745
Mailing Address - Fax:518-234-8756
Practice Address - Street 1:132 MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-3603
Practice Address - Country:US
Practice Address - Phone:518-234-8745
Practice Address - Fax:518-234-8756
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331662363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S68839Medicare UPIN
NYCC1966Medicare ID - Type Unspecified