Provider Demographics
NPI:1285021923
Name:JAY, LASHANA DARLENE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LASHANA
Middle Name:DARLENE
Last Name:JAY
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 1:1221 HINCHEY RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-2736
Mailing Address - Country:US
Mailing Address - Phone:585-747-1497
Mailing Address - Fax:
Practice Address - Street 1:1221 HINCHEY RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-2736
Practice Address - Country:US
Practice Address - Phone:585-747-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318238164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse