Provider Demographics
NPI:1114616448
Name:GARNETT, JENNIFER THERESE (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:THERESE
Last Name:GARNETT
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 1:43 DELANCEY DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-2809
Mailing Address - Country:US
Mailing Address - Phone:803-225-5145
Mailing Address - Fax:
Practice Address - Street 1:43 DELANCEY DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-2809
Practice Address - Country:US
Practice Address - Phone:803-225-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273939164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse