Provider Demographics
NPI:1598412223
Name:DINET, DEVEN MICHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEVEN
Middle Name:MICHELLE
Last Name:DINET
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 1:3146 BEAVER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-1706
Mailing Address - Country:US
Mailing Address - Phone:325-380-0988
Mailing Address - Fax:
Practice Address - Street 1:3146 BEAVER BROOK LN
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-1706
Practice Address - Country:US
Practice Address - Phone:325-380-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310247-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse