Provider Demographics
NPI:1346522091
Name:MAYNES, NOREEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:NOREEN
Middle Name:
Last Name:MAYNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 N COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2000
Mailing Address - Country:US
Mailing Address - Phone:631-474-7258
Mailing Address - Fax:631-474-0362
Practice Address - Street 1:191 N COUNTRY RD
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2000
Practice Address - Country:US
Practice Address - Phone:631-474-7258
Practice Address - Fax:631-474-0362
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349020-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool