Provider Demographics
NPI:1013293661
Name:EVERETT, DENISE ANNETTE (RN)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ANNETTE
Last Name:EVERETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 FOLEY RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:13865-1007
Mailing Address - Country:US
Mailing Address - Phone:607-775-4833
Mailing Address - Fax:607-775-4835
Practice Address - Street 1:440 FOLEY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:13865-1007
Practice Address - Country:US
Practice Address - Phone:607-775-4833
Practice Address - Fax:607-775-4835
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY445319-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool