Provider Demographics
NPI:1700283777
Name:LEVERT, TEMIKA
Entity Type:Individual
Prefix:
First Name:TEMIKA
Middle Name:
Last Name:LEVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 EDGECREEK TRL
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-1880
Mailing Address - Country:US
Mailing Address - Phone:585-764-8320
Mailing Address - Fax:
Practice Address - Street 1:737 EDGECREEK TRL
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-1880
Practice Address - Country:US
Practice Address - Phone:585-764-8320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse