Individual
BETTY WHEELER DEJAIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5 NICHOLS RD UNIT 300, ADDISON, NY 14801-1037
(607) 590-8936
Mailing address
5 NICHOLS RD, ADDISON, NY 14801-1037
(607) 590-8936
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
315365
NY
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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