Individual
LAURIE-JEAN MARIE PREMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
490 E RIDGE RD, ROCHESTER, NY 14621-1229
(585) 922-2570
(585) 922-2646
Mailing address
490 E RIDGE RD, ROCHESTER, NY 14621-1229
(585) 922-2570
(585) 922-2646
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
345791
NY
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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