Marie Isabella Holland, LPN

Individual provider Active NPI Registered Nurse · Lake Peekskill, NY

NPI 1356527014 · NPPES record last updated Dec 23, 2024

Key facts

NPI
1356527014
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
785986-01 (NY)
Practice address
45 Morrissey Dr
Lake Peekskill, NY 10537-1219
Phone
(845) 284-2494
NPI assigned
Jan 12, 2008
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

LicenseStateTypeSpecialty
785986-01NYMDRegistered Nurse
217936-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 217936-1 NY
Registered Nurse 163W00000X 785986-01 NY Yes

Addresses

Primary practice location

45 Morrissey Dr
Lake Peekskill, NY 10537-1219

Mailing address

45 Morrissey Dr
Lake Peekskill, NY 10537-1219
Phone (845) 661-6916

Other identifiers

IdentifierTypeStateIssuer
01779304MedicaidNY

Other names

  • Ms. Marie Isabella Deye Former name

Other providers in Lake Peekskill, NY

All providers in Lake Peekskill, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.