Provider Demographics
NPI:1760706956
Name:CURTIS, LENEE M (LPN)
Entity Type:Individual
Prefix:
First Name:LENEE
Middle Name:M
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LENEE
Other - Middle Name:M
Other - Last Name:HAVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:115 BUTLER LN
Mailing Address - Street 2:
Mailing Address - City:DRIGGS
Mailing Address - State:ID
Mailing Address - Zip Code:83422-4816
Mailing Address - Country:US
Mailing Address - Phone:208-354-2717
Mailing Address - Fax:
Practice Address - Street 1:115 BUTLER LN
Practice Address - Street 2:
Practice Address - City:DRIGGS
Practice Address - State:ID
Practice Address - Zip Code:83422-4816
Practice Address - Country:US
Practice Address - Phone:208-354-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPN-10939164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse