Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
May 9, 2016
License(s)
SP016446 (PA), 343525 (NY), F343525-1 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 191 N MAIN ST | Wellsville, NY 14895-1489 | 585-596-0134 |
| MAILING | 191 NORTH MAIN STREET PO BOX 72 | Wellsville, NY 14895-0072 | 585-593-1100 |
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