Provider Demographics
NPI:1467216374
Name:DELL, JODYANN (LPN)
Entity Type:Individual
Prefix:
First Name:JODYANN
Middle Name:
Last Name:DELL
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 1:2157 ROUTE 44
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VLY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-7375
Mailing Address - Country:US
Mailing Address - Phone:718-678-5023
Mailing Address - Fax:
Practice Address - Street 1:45 KNOLLWOOD RD STE 102
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-2806
Practice Address - Country:US
Practice Address - Phone:914-510-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349424164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse