Jessie James Dwyer, LPN

Individual provider Active NPI Licensed Practical Nurse · Memphis, NY

NPI 1497982367 · NPPES record last updated Jun 17, 2009

Key facts

NPI
1497982367
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
294649-1 (NY)
Practice address
1120 Morgan Rd
Memphis, NY 13112-8717
Phone
(315) 708-2291
NPI assigned
Jun 17, 2009
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
294649-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 294649-1 NY Yes

Addresses

Primary practice location

1120 Morgan Rd
Memphis, NY 13112-8717

Mailing address

1120 Morgan Rd
Memphis, NY 13112-8717
Phone (315) 708-2291

Other providers in Memphis, NY

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

Sources for this page

Verify at the official NPI Registry.