Healthcare Provider Details

I. General information

NPI: 1386010742
Provider Name (Legal Business Name): KRISTEN ESTELLE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1548 SCHLEGEL RD
WEBSTER NY
14580-8506
US

IV. Provider business mailing address

1548 SCHLEGEL RD
WEBSTER NY
14580-8506
US

V. Phone/Fax

Practice location:
  • Phone: 585-265-2500
  • Fax:
Mailing address:
  • Phone: 585-265-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number607761-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: