Betty Wheeler Dejaiffe, LPN

Individual provider Active NPI Licensed Practical Nurse · Addison, NY

NPI 1053185033 · NPPES record last updated Nov 10, 2023

Key facts

NPI
1053185033
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
315365 (NY)
Practice address
5 Nichols Rd Unit 300
Addison, NY 14801-1037
Phone
(607) 590-8936
NPI assigned
Nov 10, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
164W00000X 315365 NY Yes

Addresses

Primary practice location

5 Nichols Rd Unit 300
Addison, NY 14801-1037

Mailing address

5 Nichols Rd
Addison, NY 14801-1037
Phone (607) 590-8936

Other providers in Addison, NY

All providers in Addison, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.