Provider Demographics
NPI:1972199297
Name:MCLAUGHLIN, JEAN PATRICE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:PATRICE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:JEAN
Other - Middle Name:PATRICE
Other - Last Name:GANONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4 DANFORTH RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-3635
Mailing Address - Country:US
Mailing Address - Phone:518-334-2654
Mailing Address - Fax:
Practice Address - Street 1:4 DANFORTH RD
Practice Address - Street 2:
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-3635
Practice Address - Country:US
Practice Address - Phone:518-334-2654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1026578163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse