Individual
TRENT VERNON WYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1183 MONROE AVE, ROCHESTER, NY 14620-1662
(585) 256-7500
Mailing address
529 GARNSEY RD, FAIRPORT, NY 14450-3924
(585) 645-8073
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
750145-01
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F406369-01
NY
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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