Individual
ANDRENNA BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 RUGBY AVE, ROCHESTER, NY 14619-1139
(585) 690-8455
Mailing address
225 RUGBY AVE, ROCHESTER, NY 14619-1139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
897313
NY
164W00000X
Licensed Practical Nurse
9585350
NY
Other
Enumeration date
05/11/2017
Last updated
07/19/2023
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