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Individual

KIM W PAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 273-3962
Mailing address
601 ELMWOOD AVE, BOX 670, ROCHESTER, NY 14642-0001
(585) 273-3962
(585) 276-2663

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
452553
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
301654
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03306705
NY
Enumeration date
10/03/2006
Last updated
07/05/2023
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