National Provider Identifier
Katherine Phouthavong, N.P.
Katherine Phouthavong, N.P. is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Rochester, NY and a listed phone number of (585) 275-5875.
Profile Overview
- NPI
- 1033669726
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- October 06, 2016
- Last Updated
- October 06, 2016
Practice Location
- 601 Elwood Ave
- Box Surg/Txp
- Rochester, NY 14642-0001
Phone: (585) 275-5875
Mailing Address
- 80 Derrick Dr
- West Henrietta, NY 14586-8915
Specialties
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1033669726
- Entity Type
- Individual
- Last Name
- Phouthavong
- First Name
- Katherine
- Name Prefix
- Mrs.
- Credential
- N.P.
- Mailing Street Address
- 80 Derrick Dr
- Mailing City
- West Henrietta
- Mailing State
- NY
- Mailing ZIP Code
- 14586-8915
- Mailing Country
- US
- Mailing Phone
- (585) 576-0290
- Practice Street Address
- 601 Elwood Ave
- Practice Address Line 2
- Box Surg/Txp
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0001
- Practice Country
- US
- Practice Phone
- (585) 275-5875
- Enumeration Date
- October 06, 2016
- Last Updated
- October 06, 2016
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X)