Individual provider Active NPI

Envetha Stetson, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1710351101
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2443441 Issued in NY
Practice address
434 Lincoln Ave Apt 2
Brooklyn, NY 11208-3019
Phone
(347) 621-5712
NPI assigned
Nov 23, 2015
Last updated
Nov 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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 2443441 NY Primary

Addresses

Primary practice location

434 Lincoln Ave Apt 2
Brooklyn, NY 11208-3019

Mailing address

1469 White Plains Road
Bronx, NY 10462
Phone (917) 215-8107

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
2443441NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1710351101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1469 WHITE PLAINS ROAD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10462",
            "telephone_number": "917-215-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 LINCOLN AVE APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083019",
            "telephone_number": "347-621-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETSON",
        "first_name": "ENVETHA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2443441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.