Provider Demographics
NPI:1639684459
Name:JONES, SOFIEANN ALICEA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:SOFIEANN
Middle Name:ALICEA
Last Name:JONES
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 1:87 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1629
Mailing Address - Country:US
Mailing Address - Phone:585-764-2438
Mailing Address - Fax:585-764-2438
Practice Address - Street 1:87 BRYAN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1629
Practice Address - Country:US
Practice Address - Phone:585-764-2438
Practice Address - Fax:585-764-2438
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330861164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse