Individual
MRS. KATHLEEN ROSE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PNP-BC
Contact information
Practice address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 368-4012
(585) 723-7470
Mailing address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 368-4012
(585) 723-7470
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
380878-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000560245002
COMM BLUE
—
05
—
01877861
—
NY
01
—
9512159
IHA
—
01
—
NP0052
PREF CARE
—
Enumeration date
06/30/2005
Last updated
12/22/2022
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