Healthcare Provider Details

I. General information

NPI: 1831475698
Provider Name (Legal Business Name): VANESSA MARIE PERRY RN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 E HENRIETTA RD
ROCHESTER NY
14620-4629
US

IV. Provider business mailing address

PO BOX 143
PAW CREEK NC
28130-0143
US

V. Phone/Fax

Practice location:
  • Phone: 585-753-5927
  • Fax:
Mailing address:
  • Phone: 585-355-9192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number383264
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number636479-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: