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1134984974
KELLIE LYNN WIACKLEY
STATEN ISLAND, NY
NPI
1134984974
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 884578)
Enumeration Date
2024-02-20
Last Update Date
2024-02-20
Business Address
KELLIE LYNN WIACKLEY RN
275 CASELTON AVE
STATEN ISLAND, NY 10301
Phone number: 347-539-3670
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Mailing Address
KELLIE LYNN WIACKLEY RN
141 PELTON AVE
STATEN ISLAND, NY 10310-1543
Phone number: 347-539-3670
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