Provider Demographics
NPI:1376991661
Name:ENCK, DENISE ANN (LPN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:ENCK
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 1:1400 VILLAGE BLVD
Mailing Address - Street 2:APT 1013
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2842
Mailing Address - Country:US
Mailing Address - Phone:717-823-0028
Mailing Address - Fax:
Practice Address - Street 1:1400 VILLAGE BLVD
Practice Address - Street 2:APT 1013
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2842
Practice Address - Country:US
Practice Address - Phone:717-823-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN 5186694164W00000X
PAPN 274642164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse