Individual provider · Type 1 NPI
Kettia Charles
Family Nurse Practitioner · Syracuse, NY
NPI number
1750239208
Active
Practice location
750 E Adams St
Syracuse, NY 13210-2306
Mailing address
3 Balmville Rd
Newburgh, NY 12550-1911
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 699259 (NY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1750239208
Kettia Charles's National Provider Identifier is 1750239208, issued on Mar 19, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Syracuse, NY. The record was last updated on Mar 19, 2026.