Individual
MISS BROOKLYNN T TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
60 DODGE ST APT D, ROCHESTER, NY 14606-1524
(585) 362-2046
Mailing address
60 DODGE ST APT D, ROCHESTER, NY 14606-1524
(585) 362-2046
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337414
NY
Other
Enumeration date
05/11/2024
Last updated
05/11/2024
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