National Provider Identifier

Shanita Simone Polk, LPN

Shanita Simone Polk, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 334-9357.

NPI 1205163326Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1205163326
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
November 10, 2009
Last Updated
November 10, 2009

Practice Location

  • 48 Harwin Dr
  • Rochester, NY 14623-4716

Phone: (585) 334-9357

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1205163326
Entity Type
Individual
Last Name
Polk
First Name
Shanita
Middle Name
Simone
Name Prefix
MS.
Credential
LPN
Mailing Street Address
48 Harwin Dr
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14623-4716
Mailing Country
US
Mailing Phone
(585) 334-9357
Practice Street Address
48 Harwin Dr
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14623-4716
Practice Country
US
Practice Phone
(585) 334-9357
Enumeration Date
November 10, 2009
Last Updated
November 10, 2009
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)