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NPI Code Detail

MEDICARE: MYRLENE LAURORE RN

MEDICARE:   MYRLENE  LAURORE  RN
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
1163W00000XRegistered Nurse607895-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568706265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRLENE LAURORE RN
Provider Business Mailing Address
First Line : 3509 JOHN PAUL JONES LN
Second Line :
City : NEW WINDSOR
State : NY
Zip : 12553-4942
Country : US
Telephone Number : 845-290-7807
Fax Number :
Provider Business Practice Location Address
First Line : 3509 JOHN PAUL JONES LN
Second Line :
City : NEW WINDSOR
State : NY
Zip : 12553-4942
Country : US
Telephone Number : 845-290-7807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2012
Last Update Date : 11/19/2012

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