Provider Demographics
NPI:1285129098
Name:DUKES, INEZ JUSTINE (LPN)
Entity type:Individual
Prefix:
First Name:INEZ
Middle Name:JUSTINE
Last Name:DUKES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:INEZ
Other - Middle Name:JUSTINE
Other - Last Name:DUKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:INEZ J DUKES
Mailing Address - Street 1:13 FRANK ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-3106
Mailing Address - Country:US
Mailing Address - Phone:518-429-5975
Mailing Address - Fax:
Practice Address - Street 1:13 FRANK ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-3106
Practice Address - Country:US
Practice Address - Phone:518-429-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299752-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$Medicaid