Individual
BRIDGETTE ELLENWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
22 FAIRVIEW AVE, ROCHESTER, NY 14619-2216
(585) 235-3430
Mailing address
22 FAIRVIEW AVE, ROCHESTER, NY 14619-2216
(585) 235-3430
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
281266
NY
Other
Enumeration date
05/17/2012
Last updated
05/17/2012
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