Healthcare Provider Details

I. General information

NPI: 1922064393
Provider Name (Legal Business Name): NATALIE ANN PASSMORE ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 ORCHARD PARK RD D
ORCHARD PARK NY
14127-1208
US

IV. Provider business mailing address

3041 ORCHARD PARK RD D
ORCHARD PARK NY
14127-1208
US

V. Phone/Fax

Practice location:
  • Phone: 716-671-8393
  • Fax: 716-671-8398
Mailing address:
  • Phone: 716-671-8393
  • Fax: 716-671-8398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF3039321
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: