Doctor Name: | MRS. JACQUELINE BRUTUS LAGUERRE |
NPI Number: | 1992062467 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 416289 |
Business Practice Address: | 183 E Main St Washingtonville, NY - 109921753 |
Business Phone Number: | 8454595674 |
Business Fax Number: | |
Mailing Address: | 183 E Main St, WASHINGTONVILLE |
State: | NY |
Postal Code: | 109921753 |
Phone Number: | 8454595674 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2012 |
NPI Last Update Date: | 04/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0809X |
License Number: | 416289 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |