Individual
ANDREA NOELLE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
411 W 3RD ST, JAMESTOWN, NY 14701-4801
(716) 294-5406
Mailing address
84 MYRTLE ST, JAMESTOWN, NY 14701-8053
(716) 640-0003
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
301184
NY
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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