Provider Demographics
NPI:1265670376
Name:MAKONI, DOROTHY (LPN)
Entity Type:Individual
Prefix:MISS
First Name:DOROTHY
Middle Name:
Last Name:MAKONI
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 1:128 RICHARDS AVE
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612
Mailing Address - Country:US
Mailing Address - Phone:508-797-0877
Mailing Address - Fax:
Practice Address - Street 1:128 RICHARDS AVE
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:MA
Practice Address - Zip Code:01612-1122
Practice Address - Country:US
Practice Address - Phone:508-797-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA63979164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse