Individual
KATHLEEN M ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP, RN
Contact information
Practice address
3200 WEST ST, CANANDAIGUA, NY 14424-1722
(585) 905-0061
Mailing address
3200 WEST ST, CANANDAIGUA, NY 14424-1722
(585) 905-0061
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686821
NY
164W00000X
Licensed Practical Nurse
308304
NY
363L00000X
Nurse Practitioner
Primary
308945
NY
Other
Enumeration date
08/21/2013
Last updated
11/11/2018
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