Provider Demographics
NPI:1548852676
Name:HERRING, UNITA (LPN)
Entity type:Individual
Prefix:
First Name:UNITA
Middle Name:
Last Name:HERRING
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 1:31 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3531
Mailing Address - Country:US
Mailing Address - Phone:315-254-4400
Mailing Address - Fax:
Practice Address - Street 1:31 WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3531
Practice Address - Country:US
Practice Address - Phone:315-254-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339864164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY339864OtherLPN LICENSE