Provider Demographics
NPI:1033304837
Name:EARSING, MARY ELIZABETH (LPN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:EARSING
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 1:106 TWO ROD RD
Mailing Address - Street 2:
Mailing Address - City:MARILLA
Mailing Address - State:NY
Mailing Address - Zip Code:14102-9731
Mailing Address - Country:US
Mailing Address - Phone:716-674-3689
Mailing Address - Fax:
Practice Address - Street 1:106 TWO ROD RD
Practice Address - Street 2:
Practice Address - City:MARILLA
Practice Address - State:NY
Practice Address - Zip Code:14102-9731
Practice Address - Country:US
Practice Address - Phone:716-674-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231935164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse