Provider Demographics
NPI:1598362592
Name:REMMEL, COURTNEY JO (LPN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JO
Last Name:REMMEL
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 1:410 SHORE ACRES DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-5811
Mailing Address - Country:US
Mailing Address - Phone:585-490-0076
Mailing Address - Fax:
Practice Address - Street 1:410 SHORE ACRES DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-5811
Practice Address - Country:US
Practice Address - Phone:585-490-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336835164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse