Provider Demographics
NPI:1720725799
Name:RECCHIE, CARRIE ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANN
Last Name:RECCHIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:BENEWAY/MONTFORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 NAPPY LANE
Mailing Address - Street 2:
Mailing Address - City:NAPANOCH
Mailing Address - State:NY
Mailing Address - Zip Code:12458
Mailing Address - Country:US
Mailing Address - Phone:845-705-6914
Mailing Address - Fax:
Practice Address - Street 1:15 SUFFERN PLACE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901
Practice Address - Country:US
Practice Address - Phone:845-357-4500
Practice Address - Fax:845-357-5039
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281453164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse