Individual
PATRICIA J CHAMPLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
120 GARDENVILLE PKWY W, WEST SENECA, NY 14224
(716) 668-3600
(716) 606-4003
Mailing address
800 CARTER STREET, ATTN KELLY STEELE, ROCHESTER, NY 14621
(585) 339-4793
(585) 336-4845
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
300246
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000560338004
BCBS
NY
01
—
040511000506
FIDELIS
NY
01
—
10767064
CAQH
NY
01
—
159955BJ
PREFERRED CARE
NY
01
—
9513172
IHA
NY
01
—
P00189067
MEDICARE RAILROAD
NY
Enumeration date
05/03/2006
Last updated
07/08/2007
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