Individual
ALESE NICOLE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
207 W ROSWELL AVE, NEDROW, NY 13120-1030
(315) 469-6095
Mailing address
207 W ROSWELL AVE, NEDROW, NY 13120-1030
(315) 469-6095
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
290183
NY
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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