Provider Demographics
NPI:1396493870
Name:LAMANNA, KATELYN ANN (RN)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANN
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ANN
Other - Last Name:REIBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2750 SHEPHERD RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:NY
Mailing Address - Zip Code:14589-9409
Mailing Address - Country:US
Mailing Address - Phone:585-721-4537
Mailing Address - Fax:
Practice Address - Street 1:2750 SHEPHERD RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:NY
Practice Address - Zip Code:14589-9409
Practice Address - Country:US
Practice Address - Phone:585-721-4537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1775283163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse