Kimberly L. Provenzano

NPI 1104864081 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1104864081
Gender Female
Enumeration Date 06/03/2006
Last Updated 10/24/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
1425 PORTLAND AVE
ROCHESTER NY, 14621-3001, US
Phone (585) 922-4020
Fax (585) 922-4622
Business Location
1425 PORTLAND AVE
ROCHESTER NY, 14621-3001, US
Phone (585) 922-4020
Fax (585) 922-4622
Toxanomy
Taxonomy Code 363L00000X
License State New York
License Number 370019
Remove 1104864081 NPI Number
 

According to our database, Ms. Kimberly L. Provenzano NPI is 1104864081, taxonomy code is 363L00000X and license number is 370019, license state is located at New York. Kimberly L. Provenzano physically located at 1425 Portland Ave, Rochester NY, 14621-3001. NPI Number Kimberly L. Provenzano has the Individual type.

Sponsored links

1104864081 NPI number is provided on an as is basis without warranty of any kind. 1104864081 is maintained by the National Plan & Provider Enumeration System. The contents of Kimberly L. Provenzano are for informational purposes only.