Individual
BOBBI ANNE STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
474 MOUNTAIN RD, WINDSOR, NY 13865-1737
(607) 655-1653
Mailing address
PO BOX 462, WINDSOR, NY 13865-0462
(607) 655-1653
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
128549-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01017858
—
NY
Enumeration date
10/15/2007
Last updated
10/15/2007
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