Healthcare Provider Details

I. General information

NPI: 1487963666
Provider Name (Legal Business Name): KRISTIE CHATTERTON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 ENGLISH RD
ROCHESTER NY
14616-1651
US

IV. Provider business mailing address

2245 ENGLISH RD
ROCHESTER NY
14616-1651
US

V. Phone/Fax

Practice location:
  • Phone: 585-227-3325
  • Fax: 585-227-9808
Mailing address:
  • Phone: 585-227-3325
  • Fax: 585-227-9808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number630014
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: