=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093728586
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLYN FRENCH NPP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 ELMWOOD AVE
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14642-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-275-4313
-----------------------------------------------------
Fax | 585-273-1121
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 153 WEST AVE
-----------------------------------------------------
City | FAIRPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14450-2127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-377-8288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | F400545-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------