Healthcare Provider Details

I. General information

NPI: 1467488692
Provider Name (Legal Business Name): MARGARET BROWN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

973 EAST AVE SUITE 100
ROCHESTER NY
14607-2216
US

IV. Provider business mailing address

973 EAST AVE SUITE 100
ROCHESTER NY
14607-2216
US

V. Phone/Fax

Practice location:
  • Phone: 585-244-1000
  • Fax: 585-271-4786
Mailing address:
  • Phone: 585-244-1000
  • Fax: 585-271-4786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43473
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF430974-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: