Provider Demographics
NPI:1861789232
Name:GREEN HURT, JANETTE KAREN (LPN)
Entity type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:KAREN
Last Name:GREEN HURT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:JANETTE
Other - Middle Name:KAREN
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:531 MAIN ST
Mailing Address - Street 2:APT. 1304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0105
Mailing Address - Country:US
Mailing Address - Phone:646-750-5996
Mailing Address - Fax:
Practice Address - Street 1:531 MAIN ST
Practice Address - Street 2:APT. 1304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0105
Practice Address - Country:US
Practice Address - Phone:646-750-5996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22-4496-1372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion