Healthcare Provider Details

I. General information

NPI: 1841229416
Provider Name (Legal Business Name): JEANNE M STREETER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANNE MARIE BOROWSKI

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84B N MAIN ST
WELLSVILLE NY
14895-1250
US

IV. Provider business mailing address

601 ELMWOOD AVE. BOX 679B
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-593-0519
  • Fax: 585-593-3746
Mailing address:
  • Phone: 585-593-0519
  • Fax: 585-593-3746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332224-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: