Trudy Johnette Mack LPN

NPI 1003061839 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1003061839
Gender Female
Enumeration Date 11/20/2008
Last Updated 11/20/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
165 N. WATER STREET
APT. 205
ROCHESTER NY, 14604, US
Phone (585) 286-0097
Fax
Business Location
165 N. WATER STREET
APT. 205
ROCHESTER NY, 14604, US
Phone (585) 286-0097
Fax
Toxanomy
Taxonomy Code 164W00000X
License State New York
License Number 284904
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According to our database, Mrs. Trudy Johnette Mack LPN NPI is 1003061839, taxonomy code is 164W00000X and license number is 284904, license state is located at New York. Trudy Johnette Mack LPN physically located at 165 N. Water Street, Rochester NY, 14604. NPI Number Trudy Johnette Mack LPN has the Individual type.

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1003061839 NPI number is provided on an as is basis without warranty of any kind. 1003061839 is maintained by the National Plan & Provider Enumeration System. The contents of Trudy Johnette Mack LPN are for informational purposes only.