Jamie Marie Diehl, LPN

Individual provider Active NPI Licensed Practical Nurse · Ticonderoga, NY

NPI 1144527698 · NPPES record last updated Feb 18, 2011

Key facts

NPI
1144527698
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
304861-1 (NY)
Practice address
895 Nys Route 9N
Ticonderoga, NY 12883-3207
Phone
(518) 569-0912
NPI assigned
Feb 18, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
304861-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 304861-1 NY Yes

Addresses

Primary practice location

895 Nys Route 9N
Ticonderoga, NY 12883-3207

Mailing address

PO Box 580
Ticonderoga, NY 12883-0580
Phone (518) 569-0912

Other providers in Ticonderoga, NY

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

Sources for this page

Verify at the official NPI Registry.