Provider Demographics
NPI:1396422200
Name:LEARNED, ANN MUDGETT (NP)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:MUDGETT
Last Name:LEARNED
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1399
Mailing Address - Country:US
Mailing Address - Phone:518-563-5440
Mailing Address - Fax:
Practice Address - Street 1:154 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1399
Practice Address - Country:US
Practice Address - Phone:518-563-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF311273-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health