Provider Demographics
NPI:1235463514
Name:FOREST, ALLIE CAREN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ALLIE
Middle Name:CAREN
Last Name:FOREST
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 1:267 ROCKET ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4102
Mailing Address - Country:US
Mailing Address - Phone:585-284-2618
Mailing Address - Fax:
Practice Address - Street 1:267 ROCKET ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-1406
Practice Address - Country:US
Practice Address - Phone:585-284-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-19
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278564164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse