Provider Demographics
NPI:1407177009
Name:PIERRE, ISLA (LPN)
Entity Type:Individual
Prefix:
First Name:ISLA
Middle Name:
Last Name:PIERRE
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 1:13417 166TH PL
Mailing Address - Street 2:6H
Mailing Address - City:ROCHDALE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3846
Mailing Address - Country:US
Mailing Address - Phone:718-600-6024
Mailing Address - Fax:
Practice Address - Street 1:13417 166TH PL
Practice Address - Street 2:6H
Practice Address - City:ROCHDALE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11434-3846
Practice Address - Country:US
Practice Address - Phone:718-600-6024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229650164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse