Provider Demographics
NPI:1467921395
Name:ROSS, ANNMARIE L (LPN)
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:L
Last Name:ROSS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANNMARIE
Other - Middle Name:L
Other - Last Name:BELTRONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:199 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:PURLING
Mailing Address - State:NY
Mailing Address - Zip Code:12470-3409
Mailing Address - Country:US
Mailing Address - Phone:518-965-9329
Mailing Address - Fax:
Practice Address - Street 1:199 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:PURLING
Practice Address - State:NY
Practice Address - Zip Code:12470-3409
Practice Address - Country:US
Practice Address - Phone:518-965-9329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286324-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse