Kevonna Lynessa Anderson | Rochester, NY • PECOS Search

Kevonna Lynessa Anderson

Licensed Practical Nurse

Nursing Service Providers

118 Keller St, Rochester, NY 14609-3915

PECOS Enrollment

Based on the most recent information from CMS, provider Kevonna Lynessa Anderson 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 yesterday at 12:33 PM.

Profile Details

Provider ID
1518563535
Provider Type
Individual
Full Name
Anderson, Kevonna Lynessa
Credential
LPN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/6/2020
Last Updated
12/6/2020

Contact Information

Practice Location

118 Keller St, Rochester, NY 14609-3915

Unlisted Fax

Mailing Location

118 Keller St, Rochester, NY 14609-3915

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 164W00000X Primary	Description Licensed Practical Nurse Nursing Service Providers	License 340163-01 New York