Provider Demographics
NPI:1417224882
Name:GERMANY, MARSHETT S (LPN)
Entity Type:Individual
Prefix:
First Name:MARSHETT
Middle Name:S
Last Name:GERMANY
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 1:1130 FAIRDALE GLN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-8999
Mailing Address - Country:US
Mailing Address - Phone:585-729-5022
Mailing Address - Fax:
Practice Address - Street 1:1130 FAIRDALE GLN
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NY
Practice Address - Zip Code:14425-8999
Practice Address - Country:US
Practice Address - Phone:585-729-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304596-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse