Provider Demographics
NPI:1477925402
Name:STOKES, MARYANN T (LPN)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:T
Last Name:STOKES
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 1:1174 CREEK LOCKS RD
Mailing Address - Street 2:LOT 223
Mailing Address - City:BLOOMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12411-5133
Mailing Address - Country:US
Mailing Address - Phone:845-339-6513
Mailing Address - Fax:845-331-8427
Practice Address - Street 1:138 PINE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4947
Practice Address - Country:US
Practice Address - Phone:845-331-0114
Practice Address - Fax:845-331-8427
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179402164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse