Willa Marie Huntington, NURSE LPN

Individual provider Active NPI Licensed Practical Nurse · Ticonderoga, NY

NPI 1295054146 · NPPES record last updated May 18, 2010

Key facts

NPI
1295054146
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
270460-1 (NY)
Practice address
53 Defiance St
Ticonderoga, NY 12883-1405
Phone
(518) 585-6042
NPI assigned
May 18, 2010
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
270460-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 270460-1 NY Yes

Addresses

Primary practice location

53 Defiance St
Ticonderoga, NY 12883-1405

Mailing address

53 Defiance St
Ticonderoga, NY 12883-1405
Phone (518) 585-6042

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.