Provider Demographics
NPI:1659710994
Name:MARKLAND, CAROL (LPN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MARKLAND
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 1:54 APPLEGATE DRIVE
Mailing Address - Street 2:MASTIC
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-9671
Mailing Address - Country:US
Mailing Address - Phone:347-664-1155
Mailing Address - Fax:
Practice Address - Street 1:147 VILLAGE CIR W
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-9671
Practice Address - Country:US
Practice Address - Phone:631-874-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310984164W00000X
NYF311588-01363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No164W00000XNursing Service ProvidersLicensed Practical Nurse