Healthcare Provider Details

I. General information

NPI: 1477724334
Provider Name (Legal Business Name): ANNE MARIE WEISBECK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 07/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX 689
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

35 HICKORY ST
ROCHESTER NY
14620-1211
US

V. Phone/Fax

Practice location:
  • Phone: 585-273-4524
  • Fax: 585-273-1055
Mailing address:
  • Phone: 585-546-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number22 482349
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number335605
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33 335605
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: