Provider Demographics
NPI:1598386450
Name:ROWE, LAURIE ANN (RN, MSN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:ROWE
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1966 PRE EMPTION ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-9507
Mailing Address - Country:US
Mailing Address - Phone:315-719-2501
Mailing Address - Fax:
Practice Address - Street 1:3200 WEST ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1722
Practice Address - Country:US
Practice Address - Phone:585-905-0061
Practice Address - Fax:585-412-6612
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY558535163WS0200X
NYF31009601363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WS0200XNursing Service ProvidersRegistered NurseSchool