Provider Demographics
NPI:1063868917
Name:BOYCE, JENNIFER (LPN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 MCINTYRE RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-7927
Mailing Address - Country:US
Mailing Address - Phone:585-301-1950
Mailing Address - Fax:
Practice Address - Street 1:2301 MCINTYRE RD
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-7927
Practice Address - Country:US
Practice Address - Phone:585-301-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248202-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse