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Ms. Kimberly L. Provenzano
Nurse Practitioner in Rochester, New York
NPI 1104864081

Kimberly L. Provenzano is a Nurse Practitioner based in Rochester, NY. Kimberly L. Provenzano practices in Rochester, NY. The NPI Number for Kimberly L. Provenzano is 1104864081 and holds a License No. 370019 (New York).

The current practice location address for Kimberly L. Provenzano is 1425 Portland Ave, Rochester, NY and can be reached out via phone at 585-922-4020 and via fax at 585-922-4622.

Location: 1425 Portland Ave, Rochester, NY, 14621-3001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104864081
Provider Name
Kimberly L. Provenzano
Credential
Provider Entity Type
Individual
Gender
Female
Address
1425 Portland Ave, Rochester, NY, 14621-3001
Phone Number
585-922-4020
Fax Number
585-922-4622
Provider Enumeration Date
06/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02674220 05 NY
institution
Provider Business Practice Location Address Details
Address
1425 Portland Ave
City
Rochester
State
New York
Zip
14621-3001
Phone Number
585-922-4020
Fax Number
585-922-4622
person
Provider Business Mailing Address Details
Address
1425 Portland Ave
City
Rochester
State
New York
Zip
14621-3001
Phone Number
585-922-4020
Fax Number
585-922-4622
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
370019 (New York)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Oncology
Taxonomy
364SX0200X
License No.
370019 (New York)
Definition
Definition to come...
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