Healthcare Provider Details

I. General information

NPI: 1932579190
Provider Name (Legal Business Name): NORMA JEAN HESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 ROXBURY RD
HUDSON NY
12534-3623
US

IV. Provider business mailing address

231 ROXBURY RD
HUDSON NY
12534-3623
US

V. Phone/Fax

Practice location:
  • Phone: 518-672-7182
  • Fax:
Mailing address:
  • Phone: 518-672-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number7383954
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: