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Contact Information

KELLY L BRAGAN, LPN
49 INGLESID LANE
LIVERPOOL, NY13090
 Phone: 315-461-4240
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for KELLY L BRAGAN · (Female)

NPI # 1104017524
Status Active
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 08/09/2007
Last updated 08/09/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 2621441
  • NY Medicaid 02059754
Hospital affiliation(s) Not Available
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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