Jodie Lynn Delage, LPN

Individual provider Active NPI Licensed Practical Nurse · Homer, NY

NPI 1992990733 · NPPES record last updated Sep 13, 2007

Key facts

NPI
1992990733
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
247437-1 (NY)
Practice address
82 Cayuga St
Homer, NY 13077-1234
Phone
(607) 749-3415
NPI assigned
Sep 13, 2007
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
247437-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 247437-1 NY Yes

Addresses

Primary practice location

82 Cayuga St
Homer, NY 13077-1234

Mailing address

82 Cayuga St
Homer, NY 13077-1234
Phone (607) 749-3415

Other providers in Homer, NY

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

Sources for this page

Verify at the official NPI Registry.