Provider Demographics
NPI:1558060103
Name:CURTIS, DOREEN PATRICIA (LPN)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:PATRICIA
Last Name:CURTIS
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 1:886 COLUMBIA ST STE 2-100
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2377
Mailing Address - Country:US
Mailing Address - Phone:518-948-0290
Mailing Address - Fax:
Practice Address - Street 1:886 COLUMBIA ST STE 2-100
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2377
Practice Address - Country:US
Practice Address - Phone:518-948-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258902-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse