Individual
CLARA J TUTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1363 TURNPIKE RD, NEW BERLIN, NY 13411-3823
(607) 847-8402
Mailing address
1363 TURNPIKE RD, NEW BERLIN, NY 13411-3823
(607) 847-8402
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
261129
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261129
LPN
NY
Enumeration date
10/07/2011
Last updated
10/07/2011
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