Provider Demographics
NPI:1598264988
Name:BLAIR, APRILL LAVETTE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:APRILL
Middle Name:LAVETTE
Last Name:BLAIR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:APRILL
Other - Middle Name:LAVETTE
Other - Last Name:BLAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:405 WILDER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-1864
Mailing Address - Country:US
Mailing Address - Phone:585-360-3584
Mailing Address - Fax:
Practice Address - Street 1:405 WILDER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-1864
Practice Address - Country:US
Practice Address - Phone:585-360-3584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329031-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse