Keegan Michael Scofield, NP
Nurse Practitioner, Family in Corning, NY. Individual provider (NPI-1).
NPI number1669192589
StatusActive
Last updated in NPPESSep 8, 2022
Details
- NPI
- 1669192589
- Entity type
- Individual (NPI-1)
- Name
- Mr. Keegan Michael Scofield
- Credential
- NP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2022
- Certification date
- Sep 7, 2022
- Last updated
- Sep 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 350032 | NY | Yes |
Practice location
23 W Market St Ste 101Corning, NY 14830-2600
Phone 607-846-3960 · Fax 607-973-2309
Mailing address
23 W Market St Ste 101Corning, NY 14830-2600
Phone 607-846-3960 · Fax 607-973-2309
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