Healthcare Provider Details

I. General information

NPI: 1154733343
Provider Name (Legal Business Name): TRACY DONALDSON MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 WESTFALL RD
ROCHESTER NY
14618-2634
US

IV. Provider business mailing address

600 GARSON AVE
ROCHESTER NY
14609-6343
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-6000
  • Fax: 585-461-6009
Mailing address:
  • Phone: 585-690-1497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number358961
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: