Provider Demographics
NPI:1598345605
Name:ZUFELT, KATELYN (LPN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:ZUFELT
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 1:1404 KASHONG SWITCH RD APT A
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-9781
Mailing Address - Country:US
Mailing Address - Phone:585-259-7796
Mailing Address - Fax:
Practice Address - Street 1:1131 STATE ROUTE 14
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-9631
Practice Address - Country:US
Practice Address - Phone:315-694-2680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333998164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty