Kelly A Stevens | Lancaster, NY • PECOS Search

Kelly A Stevens

Licensed Practical Nurse

Nursing Service Providers

42 Iroquois Ave, Lancaster, NY 14086-1706

PECOS Enrollment

Based on the most recent information from CMS, provider Kelly A Stevens does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1407196868
Provider Type
Individual
Full Name
Stevens, Kelly A
Credential
LPN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/22/2013
Last Updated
2/22/2013

Contact Information

Practice Location

42 Iroquois Ave, Lancaster, NY 14086-1706

Unlisted Fax

Mailing Location

42 Iroquois Ave, Lancaster, NY 14086-1706

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 164W00000X Primary	Description Licensed Practical Nurse Nursing Service Providers	License 10-306345 New York