Individual provider Active NPI

Liandra Darice Creary-Miller, LPN

  • Licensed Practical Nurse
  • Poughkeepsie, NY
National Provider Identifier
1174709158
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
277241-1 Issued in NY
Practice address
142 Cannon St
Poughkeepsie, NY 12601-3423
Phone
(845) 471-3750
NPI assigned
Jan 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 277241-1 NY Primary

Addresses

Primary practice location

142 Cannon St
Poughkeepsie, NY 12601-3423

Mailing address

142 Cannon St
Poughkeepsie, NY 12601-3424
Phone (845) 471-3750

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
277241-1NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1174709158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 CANNON ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013424",
            "telephone_number": "845-471-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 CANNON ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013423",
            "telephone_number": "845-471-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREARY-MILLER",
        "first_name": "LIANDRA",
        "middle_name": "DARICE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "277241-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.