Individual
CHANEISSE REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
424 CLAY AVE, ROCHESTER, NY 14613-1026
(585) 719-5638
Mailing address
424 CLAY AVE, ROCHESTER, NY 14613-1026
(585) 719-5638
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
878152
NY
164W00000X
Licensed Practical Nurse
316375
NY
Other
Enumeration date
12/07/2013
Last updated
04/24/2024
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