Carla Jeanne Mlott, L.P.N.
Individual provider Active NPI Licensed Practical Nurse · Canisteo, NY
NPI 1124145248 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1124145248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 176416 (NY)
- Practice address
- 2701 County Route 119
Canisteo, NY 14823-9654 - Phone
- (607) 698-2641
- NPI assigned
- Mar 23, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 176416 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 176416 | NY | Yes |
Addresses
Primary practice location
2701 County Route 119
Canisteo, NY 14823-9654
Mailing address
2701 County Route 119
Canisteo, NY 14823-9654
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02049874 | Medicaid | NY |
Other providers in Canisteo, NY
- Jessica Lee Hulett
- Terrah Dawn Jones
- Michelle Leach
- Lincare Inc.
- Nora Anne Little
- Andrew Robert Morling
- Marcy Ann Morling
- Suzanne M Scott
- Steed Enterprises, LLC
- Beverly Vantreese
All providers in Canisteo, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.