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PROF. DALE ARMETTA DOUGLAS I L.P.N
NPI 1639368640
Licensed Practical Nurse in Chittenango, NY

Active since October 16, 2007
130 MALLARD BAY, CHITTENANGO, NY 13037(315) 633-0136 Get Directions Write a Review

NPPES record last updated: October 16, 2007. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Prof. Dale Armetta Douglas I L.p.n NPPES

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

PROF. DALE ARMETTA DOUGLAS I L.P.N (NPI 1639368640) is an individual licensed practical nurse in Chittenango, New York, licensed in New York (118687) and active in the NPI registry since October 2007.

NPPES Registry Identity

NPI1639368640
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NamePROF. DALE ARMETTA DOUGLAS ICredential: L.P.N
Location Address130 MALLARD BAYChittenango, NY 13037-9553
Mailing Address130 Mallard BayChittenango, NY 13037-9553 · (315) 633-0136
Phone(315) 633-0136
Sole ProprietorYes
Enumeration DateOctober 16, 2007
✔ NPI 1639368640 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 · 118687
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.
130 MALLARD BAY, Chittenango, NY 13037
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Other Identifiers 1

Medicaid02833356NY

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 Dale Douglas's NPI number?

The NPI number for Dale Douglas is 1639368640. It was assigned to this individual provider in the NPPES registry on October 16, 2007.

Where is Dale Douglas located?

Dale Douglas practices at 130 Mallard Bay, Chittenango, NY 13037. The listed phone number is (315) 633-0136.

What is Dale Douglas'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 Dale Douglas was last updated on October 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.