Individual
SHANE LAWRENCE GURNEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN BSN
Contact information
Practice address
111 WESTFALL RD, ROCHESTER, NY 14620-4647
(585) 753-5178
Mailing address
100 CARPENTER LN APT 207, PENN YAN, NY 14527-8756
(585) 753-5187
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
659843-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VYT200514960
—
NY
Enumeration date
08/28/2012
Last updated
08/28/2012
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