Provider Demographics
NPI:1659627636
Name:PROCTOR, ARLENE MARIA (RN, CPN)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:MARIA
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:RN, CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1421
Mailing Address - Country:US
Mailing Address - Phone:845-855-1054
Mailing Address - Fax:
Practice Address - Street 1:8 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-1421
Practice Address - Country:US
Practice Address - Phone:845-855-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY392623163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics