Individual
COLLEEN ANN MIDDLEBROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
159 STATE ROUTE 96, GENEVA, NY 14456-9559
(315) 521-1253
Mailing address
159 STATE ROUTE 96, GENEVA, NY 14456-9559
(315) 521-1253
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304120-01
NY
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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