Provider Demographics
NPI:1649916958
Name:DEON, GENEVIEVE ROSE (RN)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:ROSE
Last Name:DEON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:ROSE
Other - Last Name:AARON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:637 COUNTY ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:FORT COVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12937-2807
Mailing Address - Country:US
Mailing Address - Phone:518-358-6600
Mailing Address - Fax:518-358-2134
Practice Address - Street 1:637 COUNTY ROUTE 1
Practice Address - Street 2:
Practice Address - City:FORT COVINGTON
Practice Address - State:NY
Practice Address - Zip Code:12937-2807
Practice Address - Country:US
Practice Address - Phone:518-358-6600
Practice Address - Fax:518-358-2134
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY708416163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool