Provider Demographics
NPI:1407000805
Name:SERVICE, LAUNA BERNETTA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LAUNA
Middle Name:BERNETTA
Last Name:SERVICE
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 1:3429 HUNTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1508
Mailing Address - Country:US
Mailing Address - Phone:718-862-2992
Mailing Address - Fax:
Practice Address - Street 1:10 NIMITZ PL
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1308
Practice Address - Country:US
Practice Address - Phone:914-419-6606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253094-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse