MRS. TRUDY JOHNETTE MACK (NPI# 1003061839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003061839 |
| Entity Type | Individual |
| Full Name | MRS. TRUDY JOHNETTE MACK |
| Credential | LPN |
| Practice Address |
165 N. Water Street Apt. 205 Rochester NY 14604 |
| Practice Telephone | 5852860097 |
| Mailing Telephone | 5852860097 |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 284904 | NY | Nursing Service Providers |
| Street Address |
165 N. WATER STREET APT. 205 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225562481 | Katherine Nielsen-erskine | Registered Nurse | 1645 Saint Paul, Rochester, NY 14604 | 2017-04-14 |
| 1245787456 | The Young Men's Christian Association of Greater Rochester | Health Educator | 444 E Main St, Rochester, NY 14604 | 2016-09-06 |
| 1093146565 | Allyson Stoughton | Case Manager/Care Coordinator | 87 North Clinton Avenue, Rochester, NY 14604 | 2013-12-09 |
| 1730336124 | Berkshire Farm Center &services for Youth | Community/Behavioral Health | 1059 Sibley Tower Bldg, Rochester, NY 14604 | 2008-08-27 |
| 1851430813 | Berkshire Farm Center and Services for Youth | Case Management | 1059 Silbey Tower Building, Medicaid Service Coordination Program, Rochester, NY 14604 | 2007-02-06 |
| 1982779930 | Jeremy Alan Leichtner | Dentist | 1158 Sibley Tower Bldg, Rochester, NY 14604 | 2006-11-22 |
| 1518589761 | Dillon Jay Auvenshine | Student in an Organized Health Care Education/Training Program | 300 Crittenden Blvd, Rochester, NY 14604 | 2020-05-11 |
| 1235597394 | Jessica Pruitt | Counselor | 87 N Clinton Ave, Rochester, NY 14604 | 2016-02-04 |
| 1033520440 | Huther Doyle Memorial Institute | Counselor | 360 East Ave, Rochester, NY 14604 | 2014-05-20 |
| 1295146652 | Jose Rivera | Counselor | 360 East Ave, Rochester, NY 14604 | 2014-05-19 |
| Find all providers in zip 14604 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| 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. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689664 | Chynna S Brown | Licensed Practical Nurse | 483 Newbury St, Rochester, NY 14615-3209 | 2020-11-06 |
| 1992305775 | Sharee Walker | Licensed Practical Nurse | 145 Atlantic Ave, Rochester, NY 14607-1205 | 2020-10-29 |
| 1932708401 | Tatyanna Greene | Licensed Practical Nurse | 160 Calm Lake Cir Apt C, Rochester, NY 14612-2512 | 2020-10-25 |
| 1750989158 | Toni Foster | Licensed Practical Nurse | 72 Melrose St, Rochester, NY 14619-1802 | 2020-10-16 |
| 1861090474 | Jovon C Johnson | Licensed Practical Nurse | 24 Alfie Dr, Rochester, NY 14623-3602 | 2020-10-15 |
| 1124626031 | Heavenlee Joy Henderson | Licensed Practical Nurse | 61 Farleigh Ave, Rochester, NY 14606-2007 | 2020-10-13 |
| 1245838259 | Sherree Daniella Holloway | Licensed Practical Nurse | 156 Normandy Ave, Rochester, NY 14619-1132 | 2020-10-12 |
| 1912505173 | Robin R Graham | Licensed Practical Nurse | 70 Devon Rd, Rochester, NY 14619-2402 | 2020-10-10 |
| 1568060705 | Jasmine Daja Shannay Vick | Licensed Practical Nurse | 619 Arnett Blvd, Rochester, NY 14619-1308 | 2020-10-10 |
| 1790383925 | Nikki Pickett | Licensed Practical Nurse | 118 Hazelwood Ter, Rochester, NY 14609-5133 | 2020-10-10 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.