Provider Demographics
NPI:1003124199
Name:TEDONE, KRISTEN L (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:L
Last Name:TEDONE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ISLAND COTTAGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3626
Mailing Address - Country:US
Mailing Address - Phone:585-966-3000
Mailing Address - Fax:
Practice Address - Street 1:120 ISLAND COTTAGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3626
Practice Address - Country:US
Practice Address - Phone:585-966-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY499703163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool