Hannes Nose, LPN

Individual provider Active NPI Licensed Practical Nurse · Corona, NY

NPI 1992045306 · NPPES record last updated Feb 21, 2013

Key facts

NPI
1992045306
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
291516-1 (NY)
Practice address
10823 36TH Ave
Corona, NY 11368-1205
Phone
(917) 337-2618
NPI assigned
Feb 21, 2013
Sex
Male
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
291516-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 291516-1 NY Yes

Addresses

Primary practice location

10823 36TH Ave
Corona, NY 11368-1205

Mailing address

108-23 36TH Avenue
Corona, NY 11368
Phone (917) 337-2618

Other providers in Corona, NY

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

Sources for this page

Verify at the official NPI Registry.