Provider Demographics
NPI:1295453058
Name:FORYT, KRISTIE JO (RN)
Entity type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:JO
Last Name:FORYT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CATTARAGUS DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5153
Mailing Address - Country:US
Mailing Address - Phone:585-520-8215
Mailing Address - Fax:
Practice Address - Street 1:2034 LEHIGH STATION RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9616
Practice Address - Country:US
Practice Address - Phone:585-520-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY483342-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool