Cheryl Provencher, LPN | |
15 Fortune Rd W, Middletown, NY 10941-1625 | |
(518) 477-0156 | |
Not Available |
Full Name | Cheryl Provencher |
---|---|
Gender | Female |
Speciality | Licensed Practical Nurse |
Location | 15 Fortune Rd W, Middletown, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033875844 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164W00000X | Licensed Practical Nurse | 24706801 (New York) | Primary |
Mailing Address | Practice Location Address |
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Cheryl Provencher, LPN 15 Fortune Rd W, Middletown, NY 10941-1625 Ph: () - | Cheryl Provencher, LPN 15 Fortune Rd W, Middletown, NY 10941-1625 Ph: (518) 477-0156 |
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