Healthcare Provider Details

I. General information

NPI: 1255729265
Provider Name (Legal Business Name): MICHELLE MARIE WEBB RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 AVERY ST
ROCHESTER NY
14606-1903
US

IV. Provider business mailing address

167 AVERY ST
ROCHESTER NY
14606-1903
US

V. Phone/Fax

Practice location:
  • Phone: 585-313-5572
  • Fax:
Mailing address:
  • Phone: 585-313-5572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number846832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: