Provider Demographics
NPI:1902205115
Name:GIAMPIETRO, JACQUELINE NICOLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:NICOLE
Last Name:GIAMPIETRO
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 1:27 PINE AYRE DR
Mailing Address - Street 2:
Mailing Address - City:ELDRED
Mailing Address - State:NY
Mailing Address - Zip Code:12732-5400
Mailing Address - Country:US
Mailing Address - Phone:845-707-3307
Mailing Address - Fax:
Practice Address - Street 1:27 PINE AYRE DR
Practice Address - Street 2:
Practice Address - City:ELDRED
Practice Address - State:NY
Practice Address - Zip Code:12732-5400
Practice Address - Country:US
Practice Address - Phone:845-707-3307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306671164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse