Provider Demographics
NPI:1932216603
Name:KELLEHER, KATHRYN A (NP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:KELLEHER
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Gender:F
Credentials:NP
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Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX SURG
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-279-5100
Mailing Address - Fax:585-424-1008
Practice Address - Street 1:200 WHITE SPRUCE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1605
Practice Address - Country:US
Practice Address - Phone:585-279-5100
Practice Address - Fax:585-424-1008
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-07-05
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Provider Licenses
StateLicense IDTaxonomies
NY304093363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner