MRS. AMY SUE TRIVISON LPN LICENSE # 275747 NPI 1083350524

NPI Information

NPI: 1083350524
Provider Name: MRS. AMY SUE TRIVISON, LPN LICENSE # 275747
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Individual
Address:
302 CHARLANE PARKWAY
NORTH SYRACUSE, NY
ZIP 13212
Phone: (315) 402-4518
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MRS. Amy Sue Trivison, LPN LICENSE # 275747 is a licensed practical nurse in North Syracuse, NY. The provider is 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. MRS. Amy Sue Trivison, LPN LICENSE # 275747 NPI is 1083350524. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

302 CHARLANE PARKWAY
NORTH SYRACUSE, NY
ZIP 13212-211
Phone: (315) 402-4518

The enumeration date for this NPI number is 5/9/2022 and was last updated on 4/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	164W00000X	Licensed Practical Nurse		275747	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	07762027	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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