Individual
MISS LORNA LEAH JEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
65 PARK ST, WEST WING, MALONE, NY 12953-1239
(518) 483-0454
(518) 483-5567
Mailing address
65 PARK ST, EAST WING, MALONE, NY 12953-1239
(518) 483-0454
(518) 483-5567
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
329314
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249714
—
NY
01
—
7407347
VALUE OPTIONS
NY
01
—
785899
MVP
—
Enumeration date
07/07/2005
Last updated
06/12/2015
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