Provider Demographics
NPI:1285961391
Name:WEBSTER, CHARMAINE (CNA)
Entity type:Individual
Prefix:MS
First Name:CHARMAINE
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13704 255TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2638
Mailing Address - Country:US
Mailing Address - Phone:347-869-4026
Mailing Address - Fax:
Practice Address - Street 1:13704 255TH ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2638
Practice Address - Country:US
Practice Address - Phone:347-869-4026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324813510509E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide