Provider Demographics
NPI:1285818674
Name:SUBLETT, NORMA JEAN (LPN)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:JEAN
Last Name:SUBLETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:NORMA
Other - Middle Name:JEAN
Other - Last Name:DANDRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:4676 ALBANY POST RD APT 15E2
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-3514
Mailing Address - Country:US
Mailing Address - Phone:845-233-5369
Mailing Address - Fax:
Practice Address - Street 1:4676 ALBANY POST RD APT 15E2
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-3514
Practice Address - Country:US
Practice Address - Phone:845-233-5369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291644-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse