MEDICARE: DEBORAH F. EARLEY 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
1	164W00000X	Licensed Practical Nurse	10-291640	NY

General Provider Information

NPI Number	:	1144553843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH F. EARLEY LPN

Provider Business Mailing Address
First Line	:	274 COLEBROOK DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-1902
Country	:	US
Telephone Number	:	585-342-8920
Fax Number	:

Provider Business Practice Location Address
First Line	:	274 COLEBROOK DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-1902
Country	:	US
Telephone Number	:	585-342-8920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2009
Last Update Date	:	09/12/2009

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