Provider Demographics
NPI:1144575465
Name:AVENT, MONIQUE DENELLE (LPN)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:DENELLE
Last Name:AVENT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:DENELLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:310 RENWICK AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2321
Mailing Address - Country:US
Mailing Address - Phone:315-383-3789
Mailing Address - Fax:
Practice Address - Street 1:310 RENWICK AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2321
Practice Address - Country:US
Practice Address - Phone:315-383-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281375164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse