Individual
ASHLEY RENEE TIRADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4703 NORTH ST APT A, JAMESVILLE, NY 13078-9411
(315) 640-8722
Mailing address
4703 NORTH ST APT A, JAMESVILLE, NY 13078-9411
(315) 640-8722
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316182
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
316182
LPN
NY
Enumeration date
10/16/2018
Last updated
10/16/2018
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