Basic Information
| Provider Information | |||||||||
| NPI: | 1174854269 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WERNER | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 OLD TURNPIKE ROAD | ||||||||
| Address2: | SUITE #105 | ||||||||
| City: | NANUET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456240260 | ||||||||
| FaxNumber: | 8456240264 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 OLD TURNPIKE ROAD | ||||||||
| Address2: | SUITE #105 | ||||||||
| City: | NANUET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456240260 | ||||||||
| FaxNumber: | 8456240264 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2010 | ||||||||
| LastUpdateDate: | 01/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 179945-1LPN | NY | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.