Provider Demographics
NPI:1548418171
Name:CAPUANO, KRISTIN (FNP)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:CAPUANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WHITE SPRUCE BLVD
Mailing Address - Street 2:C/O GENESEE VALLEY LASER CENTRE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1606
Mailing Address - Country:US
Mailing Address - Phone:585-424-6770
Mailing Address - Fax:585-424-6776
Practice Address - Street 1:300 WHITE SPRUCE BLVD
Practice Address - Street 2:C/O GENESEE VALLEY LASER CENTRE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1606
Practice Address - Country:US
Practice Address - Phone:585-424-6770
Practice Address - Fax:585-424-6776
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily