Provider Demographics
NPI:1780900191
Name:HARDING, DESIREE JAMELLA (ANP-C)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:JAMELLA
Last Name:HARDING
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MERIDIAN CENTRE BLVD
Mailing Address - Street 2:STE 320
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3981
Mailing Address - Country:US
Mailing Address - Phone:866-352-2356
Mailing Address - Fax:585-463-3105
Practice Address - Street 1:300 MERIDIAN CENTRE BLVD
Practice Address - Street 2:STE 320
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3981
Practice Address - Country:US
Practice Address - Phone:866-352-2356
Practice Address - Fax:585-463-3105
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305066363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health