Provider Demographics
NPI:1275886145
Name:OKEEFFE, EMILY ROSE (LPN)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ROSE
Last Name:OKEEFFE
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 1:103 S CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1815
Mailing Address - Country:US
Mailing Address - Phone:845-853-3000
Mailing Address - Fax:
Practice Address - Street 1:103 S CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-1815
Practice Address - Country:US
Practice Address - Phone:845-853-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310285164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse