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KHANTALEE SOUVANNAVONG
NPI 1487042560
Licensed Practical Nurse in Rochester, NY

Active since December 25, 2014
185 COUNTRY LN, ROCHESTER, NY 14626(585) 749-0292 Get Directions Write a Review

NPPES record last updated: December 25, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Khantalee Souvannavong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHANTALEE SOUVANNAVONG (NPI 1487042560) is an individual licensed practical nurse in Rochester, New York, licensed in New York (286904-1) and active in the NPI registry since December 2014.

NPPES Registry Identity

NPI1487042560
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKHANTALEE SOUVANNAVONG
Location Address185 COUNTRY LNRochester, NY 14626-3307
Mailing Address185 Country LnRochester, NY 14626-3307 · (585) 749-0292
Phone(585) 749-0292
Sole ProprietorYes
Enumeration DateDecember 25, 2014
✔ NPI 1487042560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 286904-1
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
185 COUNTRY LN, Rochester, NY 14626
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khantalee Souvannavong's NPI number?

The NPI number for Khantalee Souvannavong is 1487042560. It was assigned to this individual provider in the NPPES registry on December 25, 2014.

Where is Khantalee Souvannavong located?

Khantalee Souvannavong practices at 185 Country Ln, Rochester, NY 14626. The listed phone number is (585) 749-0292.

What is Khantalee Souvannavong's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Khantalee Souvannavong was last updated on December 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.