Provider Demographics
NPI:1487963666
Name:CHATTERTON, KRISTIE (RN)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:CHATTERTON
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 1:2245 ENGLISH RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1651
Mailing Address - Country:US
Mailing Address - Phone:585-227-3325
Mailing Address - Fax:585-227-9808
Practice Address - Street 1:2245 ENGLISH RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1651
Practice Address - Country:US
Practice Address - Phone:585-227-3325
Practice Address - Fax:585-227-9808
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY630014163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse