Provider Demographics
NPI:1902189525
Name:TROMBLEE, CATHERINE MAY (LPN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MAY
Last Name:TROMBLEE
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:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:MORIAH CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:12961-0106
Mailing Address - Country:US
Mailing Address - Phone:518-942-8047
Mailing Address - Fax:
Practice Address - Street 1:2617 ENSIGN POND RD
Practice Address - Street 2:
Practice Address - City:MORIAH CENTER
Practice Address - State:NY
Practice Address - Zip Code:12961-1721
Practice Address - Country:US
Practice Address - Phone:518-942-8047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280738-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse