Provider Demographics
NPI:1699440917
Name:RAY, LONNETTE LEE (LPN)
Entity type:Individual
Prefix:
First Name:LONNETTE
Middle Name:LEE
Last Name:RAY
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 1:4419 ARNOLD RD APT 101
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4724
Mailing Address - Country:US
Mailing Address - Phone:202-553-7593
Mailing Address - Fax:
Practice Address - Street 1:4419 ARNOLD RD APT 101
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4724
Practice Address - Country:US
Practice Address - Phone:202-553-7593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP53322164W00000X
VA0002083540164W00000X
DCLPN1006752164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse