Healthcare Provider Details

I. General information

NPI: 1447160312
Provider Name (Legal Business Name): KATHERINE ELENA PHD, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE HADDEN

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 S CLINTON AVE STE 440
ROCHESTER NY
14618-5719
US

IV. Provider business mailing address

1815 S CLINTON AVE STE 440
ROCHESTER NY
14618-5719
US

V. Phone/Fax

Practice location:
  • Phone: 585-305-7934
  • Fax: 833-975-0940
Mailing address:
  • Phone: 585-305-7934
  • Fax: 833-975-0940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number794751-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: