Healthcare Provider Details

I. General information

NPI: 1396678082
Provider Name (Legal Business Name): ISHMAEL APPLEWHITE CNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 WINCHESTER ST
ROCHESTER NY
14615-2337
US

IV. Provider business mailing address

247 WINCHESTER ST
ROCHESTER NY
14615-2337
US

V. Phone/Fax

Practice location:
  • Phone: 585-413-7332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number718174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: