Healthcare Provider Details

I. General information

NPI: 1053327247
Provider Name (Legal Business Name): KATHLEEN MARIE BARONE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. KATHLEEN MARIE HARRISON

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 YOUNGS RD STE 104
WILLIAMSVILLE NY
14221-8024
US

IV. Provider business mailing address

1150 YOUNGS RD STE 104
WILLIAMSVILLE NY
14221-8024
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-7990
  • Fax: 716-636-7990
Mailing address:
  • Phone: 716-636-7979
  • Fax: 716-636-7993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334027-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF-334027-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: