Individual
LISA MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-4751
Mailing address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
Taxonomy
Speciality
Code
Description
License number
State
163WX0601X
Otorhinolaryngology & Head-Neck Registered Nurse
430187
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
F430187
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP0785
PREFERRED CARE
NY
01
—
P019430187
PREFERRED CARE
NY
Enumeration date
08/14/2006
Last updated
07/05/2023
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