Susanne Mary Jayne, LPN
Individual provider Active NPI Licensed Practical Nurse · Moravia, NY
NPI 1144508581 · NPPES record last updated Aug 3, 2011
Key facts
- NPI
- 1144508581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 280642-1 (NY)
- Practice address
- 3410 White Road
Moravia, NY 13118 - Phone
- (315) 497-2625
- NPI assigned
- Aug 3, 2011
- 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 |
|---|---|---|---|
| 280642-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 280642-1 | NY | Yes |
Addresses
Primary practice location
3410 White Road
Moravia, NY 13118
Mailing address
3410 White Road
Moravia, NY 13118
Phone (315) 497-2625
Other providers in Moravia, NY
- Lindsay Devon Gaston
- Kathleen J Greene
- Howd LTC Management
- Faith Howell
- Mashelle M Jansen
- Daniel F Karn
- Catherine Impastato Keating
- Ashley Yonsook Ki
- KPH Healthcare Services, Inc.
- Paige Langtry
All providers in Moravia, 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 Aug 3, 2011. 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.