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Individual
MRS. KELLI JO LACLAIR
Active
Individual
MRS. KELLI JO LACLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1606541
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02411030
—
NY
Enumeration date
02/12/2008
Last updated
02/12/2008
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