Individual
KELLY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
96 W GIBSON ST, CANANDAIGUA, NY 14424-1453
(585) 396-3900
Mailing address
96 W GIBSON ST, CANANDAIGUA, NY 14424-1453
(585) 396-3900
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
620429
NY
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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