Provider Demographics
NPI:1447765813
Name:ESTEVE, ESTANIE (LPN)
Entity Type:Individual
Prefix:
First Name:ESTANIE
Middle Name:
Last Name:ESTEVE
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 1:606 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3808
Mailing Address - Country:US
Mailing Address - Phone:561-577-0806
Mailing Address - Fax:
Practice Address - Street 1:606 PORTER ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3808
Practice Address - Country:US
Practice Address - Phone:561-577-0806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5195088376K00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY108142OtherLPN
FL$$$$$$$$$OtherSOCIAL SECURITY
NY10-8142OtherNURSING