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1215767736
JAVONDA ENITRA MACKINS
SYRACUSE, NY
NPI
1215767736
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 341331)
Enumeration Date
2024-08-07
Last Update Date
2024-08-07
Business Address
JAVONDA ENITRA MACKINS
620 MADISON ST
SYRACUSE, NY 13210-2319
Phone number: 315-426-3985
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Mailing Address
JAVONDA ENITRA MACKINS
1147 PARK AVE
UTICA, NY 13501-3810
Phone number: 732-215-8727
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