Provider Demographics
NPI:1457660300
Name:PEARSON, KINNIECE FRANCHON (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KINNIECE
Middle Name:FRANCHON
Last Name:PEARSON
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 1:70 FAIRVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-2902
Mailing Address - Country:US
Mailing Address - Phone:910-297-1771
Mailing Address - Fax:
Practice Address - Street 1:70 FAIRVIEW BLVD
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-2902
Practice Address - Country:US
Practice Address - Phone:910-297-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269221-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse