Individual
MRS. CARLA JEANNE MLOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
2701 COUNTY ROUTE 119, CANISTEO, NY 14823-9654
(607) 698-2641
Mailing address
2701 COUNTY ROUTE 119, CANISTEO, NY 14823-9654
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
176416
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02049874
—
NY
Enumeration date
03/23/2007
Last updated
07/09/2007
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