Provider Demographics
NPI:1841229416
Name:STREETER, JEANNE M (NP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:STREETER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:MARIE
Other - Last Name:BOROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE.
Mailing Address - Street 2:BOX 679B
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-593-0519
Mailing Address - Fax:585-593-3746
Practice Address - Street 1:84B N MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1250
Practice Address - Country:US
Practice Address - Phone:585-593-0519
Practice Address - Fax:585-593-3746
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332224-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily