Provider Demographics
NPI:1760864011
Name:CARDONA, KRISTEN F (NP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:F
Last Name:CARDONA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-442-5320
Mailing Address - Fax:585-442-5526
Practice Address - Street 1:2365 S CLINTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2663
Practice Address - Country:US
Practice Address - Phone:585-442-5320
Practice Address - Fax:585-442-5526
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430908-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care