Provider Demographics
NPI:1114387107
Name:AUDET, JAMES E I (RN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:AUDET
Suffix:I
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 ROCKWELL RD
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-9640
Mailing Address - Country:US
Mailing Address - Phone:315-487-2160
Mailing Address - Fax:
Practice Address - Street 1:3875 ROCKWELL RD
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:NY
Practice Address - Zip Code:13108-9640
Practice Address - Country:US
Practice Address - Phone:315-487-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY663802163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse