National Provider Identifier

Trudy Johnette Mack, LPN

Trudy Johnette Mack, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 286-0097.

NPI 1003061839Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1003061839
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
November 20, 2008
Last Updated
November 20, 2008

Practice Location

  • 165 N. Water Street
  • Apt. 205
  • Rochester, NY 14604

Phone: (585) 286-0097

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1003061839
Entity Type
Individual
Last Name
Mack
First Name
Trudy
Middle Name
Johnette
Name Prefix
Mrs.
Credential
LPN
Mailing Street Address
165 N. Water Street
Mailing Address Line 2
Apt. 205
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14604
Mailing Country
US
Mailing Phone
(585) 286-0097
Practice Street Address
165 N. Water Street
Practice Address Line 2
Apt. 205
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14604
Practice Country
US
Practice Phone
(585) 286-0097
Enumeration Date
November 20, 2008
Last Updated
November 20, 2008
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)