Provider Demographics
NPI:1285942516
Name:AUTHENRIETH, JOAN V (RN)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:V
Last Name:AUTHENRIETH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 WASHINGTON AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-5222
Mailing Address - Country:US
Mailing Address - Phone:845-247-6926
Mailing Address - Fax:845-246-4103
Practice Address - Street 1:310 WASHINGTON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-5222
Practice Address - Country:US
Practice Address - Phone:845-247-6926
Practice Address - Fax:845-246-4103
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224486-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool