Provider Demographics
NPI:1427211838
Name:IHNE-PALMER, JUDITH (LPN)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:IHNE-PALMER
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 1:26 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2312
Mailing Address - Country:US
Mailing Address - Phone:516-939-2229
Mailing Address - Fax:516-939-2252
Practice Address - Street 1:1074 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4918
Practice Address - Country:US
Practice Address - Phone:516-939-2229
Practice Address - Fax:516-939-2252
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099010164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse