Provider Demographics
NPI:1235425679
Name:LARGENT, TAMEESHA SHANICE (LPN)
Entity Type:Individual
Prefix:
First Name:TAMEESHA
Middle Name:SHANICE
Last Name:LARGENT
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 1:192 BRAMBURY DR
Mailing Address - Street 2:APT. B
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1831
Mailing Address - Country:US
Mailing Address - Phone:585-336-9728
Mailing Address - Fax:
Practice Address - Street 1:192 BRAMBURY DR
Practice Address - Street 2:APT. B
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1831
Practice Address - Country:US
Practice Address - Phone:585-336-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302101-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse