Provider Demographics
NPI:1811258650
Name:DRYDEN, ALICE K (LPN)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:K
Last Name:DRYDEN
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 1:220 PARK ST
Mailing Address - Street 2:UNIT #4
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-1240
Mailing Address - Country:US
Mailing Address - Phone:508-455-7745
Mailing Address - Fax:
Practice Address - Street 1:220 PARK ST
Practice Address - Street 2:UNIT #4
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-1240
Practice Address - Country:US
Practice Address - Phone:508-455-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN67373164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse