Individual
CLARE KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
92 PICKEREL RD, MONROE, NY 10950-5042
(845) 783-1179
Mailing address
92 PICKEREL RD, MONROE, NY 10950-5042
(845) 783-1179
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
103100-1
NY
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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