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HERUTE-AMLAK EXTAVOUR LPN
NPI 1215318498
Licensed Practical Nurse in Staten Island, NY

Active since June 14, 2015
350 VANDERBILT AVE APT 6D, STATEN ISLAND, NY 10304(347) 797-8726 Get Directions Write a Review

NPPES record last updated: June 14, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Herute-amlak Extavour Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HERUTE-AMLAK EXTAVOUR LPN (NPI 1215318498) is an individual licensed practical nurse in Staten Island, New York, licensed in New York (315213) and active in the NPI registry since June 2015.

NPPES Registry Identity

NPI1215318498
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameHERUTE-AMLAK EXTAVOURCredential: LPN
Location Address350 VANDERBILT AVE APT 6DStaten Island, NY 10304-3537
Mailing Address350 Vanderbilt Ave Apt 6dStaten Island, NY 10304-3537 · (347) 797-8726
Phone(347) 797-8726
Sole ProprietorNo
Enumeration DateJune 14, 2015
✔ NPI 1215318498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 315213
Definition
A licensed practical nurse 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.
350 VANDERBILT AVE APT 6D, Staten Island, NY 10304
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Herute-amlak Extavour's NPI number?

The NPI number for Herute-amlak Extavour is 1215318498. It was assigned to this individual provider in the NPPES registry on June 14, 2015.

Where is Herute-amlak Extavour located?

Herute-amlak Extavour practices at 350 Vanderbilt Ave Apt 6D, Staten Island, NY 10304. The listed phone number is (347) 797-8726.

What is Herute-amlak Extavour's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Herute-amlak Extavour was last updated on June 14, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.