Provider Demographics
NPI:1205119856
Name:DEMERS, EMILY ANN (LPN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:DEMERS
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 1:198 BRAYTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-2965
Mailing Address - Country:US
Mailing Address - Phone:585-322-3656
Mailing Address - Fax:
Practice Address - Street 1:198 BRAYTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-2965
Practice Address - Country:US
Practice Address - Phone:585-322-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10284132164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse