National Provider Identifier Database

KELLY L BRAGAN, LPN – NPI #1104017524
Licensed Practical Nurse

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.


Contact Information

KELLY L BRAGAN, LPN
49 INGLESID LANE
LIVERPOOL, NY13090
Phone: 315-461-4240
Fax:
Website:
Specialty Taxonomy Code
* Licensed Practical Nurse 164W00000X

* Indicates primary specialty

NPI Profile & details for KELLY L BRAGAN

NPI Number 1104017524
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 08/09/2007
Last updated 08/09/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 2621441
  • NY Medicaid: 02059754
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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