Provider Demographics
NPI:1750552295
Name:MCDOWELL, HERMINE (LPN)
Entity type:Individual
Prefix:MRS
First Name:HERMINE
Middle Name:
Last Name:MCDOWELL
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 1:3311 FISH AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469
Mailing Address - Country:US
Mailing Address - Phone:646-523-2935
Mailing Address - Fax:347-275-7732
Practice Address - Street 1:3311 FISH AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2909
Practice Address - Country:US
Practice Address - Phone:646-523-2935
Practice Address - Fax:347-275-7732
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219197164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse