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.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Licensed Practical Nurse | 164W00000X |
| Licensed Vocational Nurse | 164X00000X | |
| Mental Health | 101YM0800X |
* Indicates primary specialty
| NPI Number | 1225847635 |
| Credentials | QMHP,ADMINISTRATOR |
| Entity | Individual |
| Enumeration date | 01/01/2025 |
| Last updated | 01/01/2025 - More than a year ago |
| Sole proprietor1 | Yes |
| Identifiers |
|
| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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