Provider Demographics
NPI:1184997579
Name:FIRKINS, JESSICA ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANN
Last Name:FIRKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:FIRKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:43 LIVINGSTON PL
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-2517
Mailing Address - Country:US
Mailing Address - Phone:716-255-1434
Mailing Address - Fax:
Practice Address - Street 1:50 OLCOTT PL
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-3953
Practice Address - Country:US
Practice Address - Phone:716-897-9649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304395164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse