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General NPI Number Information
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NPI Number | 1659881555
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Entity Type | Individual
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Provider Name | KIM LETOURNEAU RN
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Gender | Female
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 103 ROUTE 276
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City | CHAMPLAIN
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State | NY
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Zip | 12919
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Country | US
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Telephone | 518-298-8638
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Fax | 518-298-2873
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Provider Business Mailing Address
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Address Line | 12 TRAHAN DR
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City | ROUSES POINT
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State | NY
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Zip | 12979-1512
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Country | US
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Telephone | 518-297-3344
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 476565-1
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License Number State | NY
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