Provider Demographics
NPI:1538041421
Name:HOUGH, PAIGE JEDON (LPN)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:JEDON
Last Name:HOUGH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BURGARD PL
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14211-2423
Mailing Address - Country:US
Mailing Address - Phone:716-247-0805
Mailing Address - Fax:
Practice Address - Street 1:103 BURGARD PL
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14211-2423
Practice Address - Country:US
Practice Address - Phone:716-247-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340451164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse