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Individual

JAMIE FAUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
100 PINEWILD DR STE 2A, ROCHESTER, NY 14606-4200
(585) 368-6700
(585) 368-6767
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 368-6700
(585) 368-6767

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
402897
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95002650
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP124349
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
325599402
TX
Enumeration date
10/25/2012
Last updated
09/06/2022
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