Amanda Mary Hurrinus I, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

337340 Issued in NY

Practice address

161 Lake Shore Rd
Lake Ronkonkoma, NY 11779-3194

Phone

(631) 471-5666

NPI assigned

Jul 18, 2022

Last updated

Jul 18, 2022By the provider in NPPES

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

Other identifiers 1

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1710612585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E MAIN ST APT 227",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012458",
            "telephone_number": "631-428-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 LAKE SHORE RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117793194",
            "telephone_number": "631-471-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURRINUS",
        "first_name": "AMANDA",
        "middle_name": "MARY",
        "name_prefix": "Miss",
        "name_suffix": "I",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "337340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164W00000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, 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 Jul 18, 2022; 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.