Provider Demographics
NPI:1740995448
Name:TONETTI, JACQUELINE ANN (RN)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANN
Last Name:TONETTI
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 1:9 NEUCHATEL LN
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-4623
Mailing Address - Country:US
Mailing Address - Phone:585-507-8442
Mailing Address - Fax:
Practice Address - Street 1:111 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4680
Practice Address - Country:US
Practice Address - Phone:585-753-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY373072-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse