Individual
MS. DIAMOND JUILET ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 PORTLAND AVE, ROCHESTER, NY 14621-3038
(585) 922-0930
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
308353
NY
363LF0000X
Family Nurse Practitioner
Primary
352249
NY
Other
Enumeration date
02/06/2012
Last updated
08/01/2024
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