Provider Demographics
NPI:1154630663
Name:DUNCAN, KELLIANN (NP)
Entity type:Individual
Prefix:
First Name:KELLIANN
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KELLIANN
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3 CALIFORNIA PL S
Mailing Address - Street 2:
Mailing Address - City:ISLAND PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11558-2216
Mailing Address - Country:US
Mailing Address - Phone:516-431-0698
Mailing Address - Fax:516-431-0698
Practice Address - Street 1:185 CENTRAL AVE.
Practice Address - Street 2:DEPARTMENT OF CARDIOLOGY
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-1171
Practice Address - Country:US
Practice Address - Phone:516-758-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY629460-1163W00000X, 163WG0000X
NY350071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice