Provider Demographics
NPI:1326642604
Name:LAMARRE, EDITH (LPN)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:LAMARRE
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 1:5700 COPPER CREEK CT APT 10
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3700
Mailing Address - Country:US
Mailing Address - Phone:857-237-8855
Mailing Address - Fax:
Practice Address - Street 1:5700 COPPER CREEK CT APT 10
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-3700
Practice Address - Country:US
Practice Address - Phone:857-237-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC88622164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty