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NPI 1548703648

NPI 1548703648 : MONICA MORSE LPN : CLINTON, NY

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General NPI Number Information
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    NPI Number           |    1548703648
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    Entity Type          |    Individual 
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    Provider Name        |    MONICA MORSE LPN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/22/2016
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    Last Update Date     |    11/22/2016
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Provider Practice Location Address
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    Address Line         |    3283 STATE ROUTE 12B 
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    City                 |    CLINTON
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    State                |    NY
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    Zip                  |    13323-4622
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    Country              |    US
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    Telephone            |    315-219-5032
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3283 STATE ROUTE 12B 
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    City                 |    CLINTON
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    State                |    NY
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    Zip                  |    13323-4622
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    Country              |    US
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    Telephone            |    315-219-5032
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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       |    325975-1
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    License Number State |    NY
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