National Provider Identifier
Kimberly L. Provenzano
Kimberly L. Provenzano is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Rochester, NY and a listed phone number of (585) 922-4020.
Profile Overview
- NPI
- 1104864081
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- June 03, 2006
- Last Updated
- July 28, 2023
Practice Location
- 1425 Portland Ave
- Rochester, NY 14621-3001
Phone: (585) 922-4020
Specialties
- Nurse Practitioner (363L00000X)
- Oncology Clinical Nurse Specialist (364SX0200X)
Endpoints
- kimberly.provenzano@rochesterregional.org
Direct Messaging Address | Rochester, NY 14621
Full Record
- NPI
- 1104864081
- Entity Type
- Individual
- Last Name
- Provenzano
- First Name
- Kimberly
- Middle Name
- L.
- Name Prefix
- MS.
- Mailing Street Address
- 1425 Portland Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-3001
- Mailing Country
- US
- Mailing Phone
- (585) 922-4020
- Mailing Fax
- (585) 922-4622
- Practice Street Address
- 1425 Portland Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3001
- Practice Country
- US
- Practice Phone
- (585) 922-4020
- Practice Fax
- (585) 922-4622
- Enumeration Date
- June 03, 2006
- Last Updated
- July 28, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- July 28, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X), Oncology Clinical Nurse Specialist (364SX0200X)
- Other Identifiers
- 02674220 (NY)