National Provider Identifier
Decarra D Bristow, LPN
Decarra D Bristow, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 736-0585.
Profile Overview
- NPI
- 1033745203
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- March 19, 2020
- Last Updated
- March 19, 2020
Practice Location
- 3896 Dewey Ave # 142
- Rochester, NY 14616-2527
Phone: (585) 736-0585
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1033745203
- Entity Type
- Individual
- Last Name
- Bristow
- First Name
- Decarra
- Middle Name
- D
- Credential
- LPN
- Mailing Street Address
- 3896 Dewey Ave # 142
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14616-2527
- Mailing Country
- US
- Mailing Phone
- (585) 736-0585
- Practice Street Address
- 3896 Dewey Ave # 142
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14616-2527
- Practice Country
- US
- Practice Phone
- (585) 736-0585
- Enumeration Date
- March 19, 2020
- Last Updated
- March 19, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- March 19, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)