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NPI Code Detail

MEDICARE: MRS. DIRETTA N O'LARRY LPN

MEDICARE:  MRS. DIRETTA N O'LARRY  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse279748-1NY

General Provider Information

NPI Number : 1023096906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIRETTA N O'LARRY LPN
Provider Business Mailing Address
First Line : CMR 412 BOX 891
Second Line :
City : APO
State : AE
Zip : 09165
Country : DE
Telephone Number : 3286656
Fax Number :
Provider Business Practice Location Address
First Line : CMR 442
Second Line :
City : APO
State : AE
Zip : 09165
Country : DE
Telephone Number : 496221172274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 07/21/2022

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Directions to “ MRS. DIRETTA N O'LARRY LPN” Practice Location

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