Healthcare Provider Details

I. General information

NPI: 1053020321
Provider Name (Legal Business Name): RENEE ANNE MERKLINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RENEE ANNE KAHLER

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2745 W RIDGE RD
ROCHESTER NY
14626-3038
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-225-5252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number674253-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number352350
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: