Individual
CHASITY JACQUEL MYRTHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4425 OLD RIDGE RD, WILLIAMSON, NY 14589-9363
(315) 483-3280
(315) 589-4893
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-1900
(585) 922-1002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
344413
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14480124
CAQH
NY
Enumeration date
07/03/2019
Last updated
07/03/2019
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