Marie Petell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

186536 Issued in NY

Practice address

17481 US Route 11 Lot 5R
Watertown, NY 13601-5346

Phone

(315) 286-3491

NPI assigned

Aug 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1235538240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17481 US ROUTE 11 LOT 5R",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-286-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17481 US ROUTE 11 LOT 5R",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015346",
            "telephone_number": "315-286-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETELL",
        "first_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "186536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald G Perciaccante, MD
• Kristy Marie Perez, LPN
• Jeff D Perrine, FNP
• Perry Optical (Vision Center II)
• Jennifer Nadine Perry, CRNA
• Lisa Ann Peters
• Jill Christine Peterson, DO
• Carl Anthony Petitto, OT/L
• Michael B Peyser, MD
• Sirina Phelps

• Licensed Practical Nurse in Watertown, NY
• Providers in Watertown, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.