Individual
MS. ANNETTE ELIZABETH WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
562 CARRIERE STREET, BETHPAGE, NY 11714
(631) 896-5617
Mailing address
562 CARRIERE STREET, BETHPAGE, NY 11714
(631) 896-5617
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
294717-1
NY
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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