Lissette Anne Ippolito, LPN
Licensed Practical Nurse in Miller Place, NY. Individual provider (NPI-1).
NPI number1508587015
StatusActive
Last updated in NPPESSep 5, 2022
Details
- NPI
- 1508587015
- Entity type
- Individual (NPI-1)
- Name
- Ms. Lissette Anne Ippolito
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 5, 2022
- Certification date
- Sep 4, 2022
- Last updated
- Sep 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 265451 | NY | Yes |
Practice location
78 Sweetgum LnMiller Place, NY 11764-3009
Phone 631-357-0488
Mailing address
78 Sweetgum LnMiller Place, NY 11764-3009
Phone 631-357-0488
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All 13 Licensed Practical Nurse providers in Miller Place · All 380 providers in Miller Place
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