National Provider Identifier

Mary L Clyde, LPN

Mary L Clyde, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Clifton Springs, NY and a listed phone number of (315) 462-7221.

NPI 1295962595Clifton Springs, NYLicensed Practical Nurse

Profile Overview

NPI
1295962595
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
June 15, 2009
Last Updated
June 15, 2009

Practice Location

  • 29 Crane St
  • Clifton Springs, NY 14432-1061

Phone: (315) 462-7221

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1295962595
Entity Type
Individual
Last Name
Clyde
First Name
Mary
Middle Name
L
Name Prefix
Mrs.
Credential
LPN
Provider Other Last Name
Clyde
Provider Other First Name
Mary
Provider Other Middle Name
Thayer
Provider Other Credential Text
LPN
Provider Other Last Name Type Code
2
Mailing Street Address
29 Crane St
Mailing City
Clifton Springs
Mailing State
NY
Mailing ZIP Code
14432-1061
Mailing Country
US
Mailing Phone
(315) 462-7221
Practice Street Address
29 Crane St
Practice City
Clifton Springs
Practice State
NY
Practice ZIP Code
14432-1061
Practice Country
US
Practice Phone
(315) 462-7221
Enumeration Date
June 15, 2009
Last Updated
June 15, 2009
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)