Provider Demographics
NPI:1003200973
Name:HAPPY, MIREILLE (LPN)
Entity Type:Individual
Prefix:
First Name:MIREILLE
Middle Name:
Last Name:HAPPY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 ELDER AVE
Mailing Address - Street 2:APT56A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-3413
Mailing Address - Country:US
Mailing Address - Phone:212-470-6264
Mailing Address - Fax:
Practice Address - Street 1:1105 ELDER AVE
Practice Address - Street 2:APT56A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-3413
Practice Address - Country:US
Practice Address - Phone:212-470-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289461164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse