Doctor Name: | MRS. JOANNE MARIE PRUDEN |
NPI Number: | 1699052241 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 338952-1 |
Business Practice Address: | 165 Charles St Painted Post, NY - 148701100 |
Business Phone Number: | 6076542782 |
Business Fax Number: | 6076542789 |
Mailing Address: | 165 Charles St, PAINTED POST |
State: | NY |
Postal Code: | 148701100 |
Phone Number: | 6076542782 |
Fax Number: | 6076542789 |
NPI Enumeration Date: | 11/10/2011 |
NPI Last Update Date: | 11/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 338952-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |