Provider Demographics
NPI:1508047366
Name:BAPTISTE, NATHALIE MYRTHO (LPN)
Entity Type:Individual
Prefix:MS
First Name:NATHALIE
Middle Name:MYRTHO
Last Name:BAPTISTE
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 1:29 SONYA WAY
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6257
Mailing Address - Country:US
Mailing Address - Phone:518-643-8160
Mailing Address - Fax:
Practice Address - Street 1:29 SONYA WAY
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6257
Practice Address - Country:US
Practice Address - Phone:518-643-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2453521164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01780767Medicaid