Provider Demographics
NPI:1750664041
Name:KILLEEN, NOREEN (RN)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:KILLEEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 LOWER ROCKY POINT RD
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1600
Mailing Address - Country:US
Mailing Address - Phone:631-474-2717
Mailing Address - Fax:
Practice Address - Street 1:65 LOWER ROCKY POINT RD
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-1600
Practice Address - Country:US
Practice Address - Phone:631-474-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY435399-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool