Provider Demographics
NPI:1063799922
Name:MCDONNELL, DENISE MARY (RN)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MARY
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4302
Mailing Address - Country:US
Mailing Address - Phone:518-761-6964
Mailing Address - Fax:518-761-0804
Practice Address - Street 1:37 BROAD ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4302
Practice Address - Country:US
Practice Address - Phone:518-761-6964
Practice Address - Fax:518-761-0804
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3282131163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool