Provider Demographics
NPI:1699923052
Name:STITH, DEVONNE SHERICE (LPN)
Entity type:Individual
Prefix:MS
First Name:DEVONNE
Middle Name:SHERICE
Last Name:STITH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:DEVONNE
Other - Middle Name:SHERICE
Other - Last Name:STITH-WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 MERLIN STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613
Mailing Address - Country:US
Mailing Address - Phone:585-328-7721
Mailing Address - Fax:585-328-7721
Practice Address - Street 1:110 MERLIN STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613
Practice Address - Country:US
Practice Address - Phone:585-328-7721
Practice Address - Fax:585-328-7721
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290108-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse