Provider Demographics
NPI:1285064600
Name:STRONG, KATHRYN (LPN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:STRONG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 TILDEN ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2333
Mailing Address - Country:US
Mailing Address - Phone:315-447-4042
Mailing Address - Fax:
Practice Address - Street 1:713 PARK AVE
Practice Address - Street 2:APT 3
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3033
Practice Address - Country:US
Practice Address - Phone:315-447-4042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306490164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse