Individual
MRS. KAITLYN MARIE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-2375
Mailing address
12 COUNTY FAIR DR APT 108, ROCHESTER, NY 14623-4371
(585) 472-2649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
383273
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383273
NY
Other
Enumeration date
08/09/2021
Last updated
07/17/2023
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