Individual provider · Type 1 NPI

Ivey Shaniece Rolon

Licensed Practical Nurse · Syracuse, NY

NPI number 1508726829 Active

Practice location

1011 W Genesee St Ste 3
Syracuse, NY 13204-2329

Call (315) 476-0600 Map

Mailing address

107 Endres Dr Apt 5
Mattydale, NY 13211-1131

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X33256701 (NY)

Licensed Practical Nurse: An individual 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.

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About NPI 1508726829

Ivey Shaniece Rolon's National Provider Identifier is 1508726829, issued on Nov 18, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Syracuse, NY. The record was last updated on Nov 18, 2025.