Most Relevant Information
Provider Data
| NPI Number: | 1003468273 |
| Provider Name: | KELLY LYNNE HEARNE MS, RN, PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 402731 |
Most Important Dates
| Enumeration Date: | 07/09/2019 |
| Last Updated: | 04/04/2022 |
Provider Practice Location
2215 BURDETT AVE
TROY
NY
121802466
Practice Location Phone/Fax
| Phone: | 5182713554 |
| Fax: |
Provider Mailing Location
PO BOX 14890
ALBANY
NY
122124890
Provider Mailing Phone/Fax
| Phone: | 5185255634 |
| Fax: | 5186494094 |