Provider Demographics
NPI:1477708980
Name:DUVIGNEAUD, LOUISE (LPN)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:DUVIGNEAUD
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 1:43 FOOTHILL PL
Mailing Address - Street 2:
Mailing Address - City:WHEATLEY HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11798-1426
Mailing Address - Country:US
Mailing Address - Phone:631-920-6366
Mailing Address - Fax:
Practice Address - Street 1:43 FOOTHILL PL
Practice Address - Street 2:
Practice Address - City:WHEATLEY HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11798-1426
Practice Address - Country:US
Practice Address - Phone:631-920-6366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237670164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse