MEDICARE: MRS. NANCY LEAVITT DEHMLER FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F331597	NY

General Provider Information

NPI Number	:	1659469054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY LEAVITT DEHMLER FNP

Provider Business Mailing Address
First Line	:	124 NORMAN ROAD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-1154
Country	:	US
Telephone Number	:	585-324-3415
Fax Number	:	585-324-3435

Provider Business Practice Location Address
First Line	:	124 NORMAN RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-1154
Country	:	US
Telephone Number	:	585-324-3415
Fax Number	:	585-324-3435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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