Provider Demographics
NPI:1720263957
Name:PARKHURST, JOANNE LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:LYNN
Last Name:PARKHURST
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:NY
Mailing Address - Zip Code:13114-4269
Mailing Address - Country:US
Mailing Address - Phone:315-963-4880
Mailing Address - Fax:
Practice Address - Street 1:50 GREEN RD
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:NY
Practice Address - Zip Code:13114-4269
Practice Address - Country:US
Practice Address - Phone:315-963-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02087483164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse