Provider Demographics
NPI:1053566950
Name:MCKELVEY, CATHRYN M (RN)
Entity type:Individual
Prefix:MRS
First Name:CATHRYN
Middle Name:M
Last Name:MCKELVEY
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:P.O.BOX 254
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231
Mailing Address - Country:US
Mailing Address - Phone:716-634-4130
Mailing Address - Fax:
Practice Address - Street 1:5775 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5807
Practice Address - Country:US
Practice Address - Phone:716-634-4130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY496560-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY496560-1OtherREGISTERED NURSE