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Individual

AMANDA ROSE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
89 GENESEE ST, ROCHESTER, NY 14611-3201
(585) 723-7000
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 474-1224

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
701776
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
431739
NY
363LG0600X
Gerontology Nurse Practitioner
431739
NY

Other

Enumeration date
11/17/2020
Last updated
01/18/2021
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