Provider Demographics
NPI:1356584767
Name:NAGLE, JOETTE ELIZABETH (RN)
Entity type:Individual
Prefix:MS
First Name:JOETTE
Middle Name:ELIZABETH
Last Name:NAGLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MAIN ST
Mailing Address - Street 2:PO BOX 407
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-1314
Mailing Address - Country:US
Mailing Address - Phone:585-335-5052
Mailing Address - Fax:585-335-5061
Practice Address - Street 1:141 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-1314
Practice Address - Country:US
Practice Address - Phone:585-335-5052
Practice Address - Fax:585-335-5061
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY580087-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103059AMOtherPREFERRED CARE