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NPI Code Detail

MEDICARE: KATHERINE M BENNETT ROLL CRNA

MEDICARE: KATHERINE M BENNETT ROLL CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist458423NY

General Provider Information

NPI Number : 1659336139
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE M BENNETT ROLL CRNA
Provider Business Mailing Address
First Line : 200 LINDEN OAKS
Second Line : SUITE 100
City : ROCHESTER
State : NY
Zip : 14625-2841
Country : US
Telephone Number : 585-248-9170
Fax Number :
Provider Business Practice Location Address
First Line : 10 HAGEN DR
Second Line :
City : ROCHESTER
State : NY
Zip : 14625-2660
Country : US
Telephone Number : 585-267-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 06/09/2014

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Directions to “ KATHERINE M BENNETT ROLL CRNA” Practice Location

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