Individual
ADELE KIBASUMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-6179
Mailing address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-6179
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
309592
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
309592
NY
Other
Enumeration date
02/26/2020
Last updated
05/24/2022
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