=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699213447
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARA MCALLISTER FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2017
-----------------------------------------------------
Last Update Date | 02/07/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 370 EAST RIDGE ROAD SUITE 400
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-338-8351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 523 PITTSFORD HENRIETTA TL RD
-----------------------------------------------------
City | HENRIETTA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14467-9733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-338-8351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F341311
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------