Sandra A Kenyon, LPN
Individual provider Active NPI Licensed Practical Nurse · Greece, NY
NPI 1083074967 · NPPES record last updated Mar 4, 2016
Key facts
- NPI
- 1083074967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 126128 (NY)
- Practice address
- 115 Valley Brook Cir
Greece, NY 14616-3638 - Phone
- (585) 766-3988
- NPI assigned
- Mar 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126128 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 126128 | NY | Yes |
Addresses
Primary practice location
115 Valley Brook Cir
Greece, NY 14616-3638
Mailing address
115 Valley Brook Cir
Greece, NY 14616-3638
Phone (585) 766-3988
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126128 | Other | NY | LPN |
Other providers in Greece, NY
- Greece Volunteer Ambulance Service Inc
- Chelsea Leigh Hassig
- Joanna Renea Holloway
- Patricia M Howard
- Ashlee Dawn Johnson
- Mary Beth Kolokouris
- Konya M Williams
- Indyia Samone Lawson
- Jacob Barry Leven
- Andrew Longwell
All providers in Greece, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.