Provider Demographics
NPI:1386061919
Name:FILKINS, SHIRLEY L
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:L
Last Name:FILKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3401
Mailing Address - Country:US
Mailing Address - Phone:607-737-5215
Mailing Address - Fax:607-737-5219
Practice Address - Street 1:150 LAKE ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3401
Practice Address - Country:US
Practice Address - Phone:607-737-5215
Practice Address - Fax:607-737-5219
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274697163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1023054376Medicaid