Provider Demographics
NPI:1467885681
Name:REES, JEANETTE J (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:J
Last Name:REES
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 1:3365 US ROUTE 20
Mailing Address - Street 2:
Mailing Address - City:CAZENOVIA
Mailing Address - State:NY
Mailing Address - Zip Code:13035-8411
Mailing Address - Country:US
Mailing Address - Phone:315-655-9149
Mailing Address - Fax:
Practice Address - Street 1:3365 US ROUTE 20
Practice Address - Street 2:
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035-8411
Practice Address - Country:US
Practice Address - Phone:315-655-9149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305735-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse