Provider Demographics
NPI:1831461177
Name:PARKHURST, NORENE M (LPN)
Entity Type:Individual
Prefix:
First Name:NORENE
Middle Name:M
Last Name:PARKHURST
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 1:317 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:465 N MAIN ST
Practice Address - Street 2:JOHN D. KELLY BEHAVIORAL HEALTH
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1069
Practice Address - Country:US
Practice Address - Phone:315-531-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157890164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse