National Provider Identifier
Colette Johanna Modrak, AGPCNP
Colette Johanna Modrak, AGPCNP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Rochester, NY and a listed phone number of (585) 613-5840.
Profile Overview
- NPI
- 1407666761
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- January 09, 2025
- Last Updated
- January 09, 2025
Practice Location
- 2365 S Clinton Ave
- Rochester, NY 14618-2663
Phone: (585) 613-5840
Mailing Address
- 8 Kalleston Dr
- Pittsford, NY 14534-2920
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1407666761
- Entity Type
- Individual
- Last Name
- Modrak
- First Name
- Colette
- Middle Name
- Johanna
- Name Prefix
- MS.
- Credential
- AGPCNP
- Mailing Street Address
- 8 Kalleston Dr
- Mailing City
- Pittsford
- Mailing State
- NY
- Mailing ZIP Code
- 14534-2920
- Mailing Country
- US
- Mailing Phone
- (585) 613-5840
- Practice Street Address
- 2365 S Clinton Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14618-2663
- Practice Country
- US
- Practice Phone
- (585) 613-5840
- Enumeration Date
- January 09, 2025
- Last Updated
- January 09, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 09, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X)