Provider Demographics
NPI:1548701667
Name:TONDREAU, VENEICE KADIAN (LPN)
Entity type:Individual
Prefix:
First Name:VENEICE
Middle Name:KADIAN
Last Name:TONDREAU
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 1:449 WEIR ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-4256
Mailing Address - Country:US
Mailing Address - Phone:857-869-3217
Mailing Address - Fax:
Practice Address - Street 1:449 WEIR ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-4256
Practice Address - Country:US
Practice Address - Phone:857-869-3217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN89629164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse