Provider Demographics
NPI:1386813392
Name:SANCHEZ, SHAVONNE MARIE (LPN)
Entity type:Individual
Prefix:
First Name:SHAVONNE
Middle Name:MARIE
Last Name:SANCHEZ
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 1:55 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1117
Mailing Address - Country:US
Mailing Address - Phone:585-309-4446
Mailing Address - Fax:
Practice Address - Street 1:55 SUNFLOWER DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1117
Practice Address - Country:US
Practice Address - Phone:585-309-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-23
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288960-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse