Provider Demographics
NPI:1538959036
Name:MULROY, BECKY LYNN (LPN)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:MULROY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LYNN
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218-2032
Mailing Address - Country:US
Mailing Address - Phone:716-352-9950
Mailing Address - Fax:716-725-0003
Practice Address - Street 1:119 LEONARD ST
Practice Address - Street 2:
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218-2032
Practice Address - Country:US
Practice Address - Phone:716-352-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332769164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse