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General NPI Number Information
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NPI Number | 1497114854
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Entity Type | Individual
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Provider Name | DEANNA MARIE FOWLKES-LORMINIER NURSE
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Gender | Female
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 187 PERRY ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-5221
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Country | US
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Telephone | 516-402-1426
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CLIFF AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-7103
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Country | US
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Telephone | 516-402-1426
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 279889-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 279889-1
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License Number State | NY
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