Provider Demographics
NPI:1982134037
Name:JOSEPH-CHARLES, NESLIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:NESLIE
Middle Name:
Last Name:JOSEPH-CHARLES
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 1:11 PROSPECT DR S
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2922
Mailing Address - Country:US
Mailing Address - Phone:631-223-3629
Mailing Address - Fax:
Practice Address - Street 1:11 PROSPECT DR S
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-2922
Practice Address - Country:US
Practice Address - Phone:631-223-3629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266135164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty