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General NPI Number Information
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NPI Number | 1164389466
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Entity Type | Individual
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Provider Name | JADE BERNADETTE LE ROUX LPN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 159 WOLF RD
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City | ALBANY
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State | NY
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Zip | 12205-6007
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Country | US
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Telephone | 518-437-0157
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Fax |
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Provider Business Mailing Address
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Address Line | 625 7TH AVE APT 206
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City | TROY
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State | NY
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Zip | 12182-2568
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Country | US
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Telephone | 917-686-5042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 351308
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License Number State | NY
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