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Edjeanine Boucicault, LPN
Licensed Practical Nurse in Lake Ronkonkoma, New York
NPI 1912624115

Edjeanine Boucicault is a Licensed Practical Nurse based in Lake Ronkonkoma, NY. Edjeanine Boucicault practices in Lake Ronkonkoma, NY and has the professional credentials of LPN. The NPI Number for Edjeanine Boucicault is 1912624115 and holds a License No. 332414-1 (New York).

The current practice location address for Edjeanine Boucicault is 153 Lake Shore Rd, Lake Ronkonkoma, NY and can be reached out via phone at 631-522-6876.

Location: 153 Lake Shore Rd, Lake Ronkonkoma, NY, 11779-3193
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912624115
Provider Name
Edjeanine Boucicault
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
153 Lake Shore Rd, Lake Ronkonkoma, NY, 11779-3193
Phone Number
631-522-6876
Fax Number
Provider Enumeration Date
10/27/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
153 Lake Shore Rd
City
Lake Ronkonkoma
State
New York
Zip
11779-3193
Phone Number
631-522-6876
Fax Number
person
Provider Business Mailing Address Details
Address
153 Lake Shore Rd
City
Lake Ronkonkoma
State
New York
Zip
11779-3193
Phone Number
631-522-6876
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
332414-1 (New York)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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