National Provider Identifier

Lisa Anne Dewilde, FNP

Lisa Anne Dewilde, FNP is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Rochester, NY and a listed phone number of (585) 723-7870.

NPI 1548782204Rochester, NYFamily Nurse Practitioner

Profile Overview

NPI
1548782204
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
July 13, 2017
Last Updated
March 01, 2018

Practice Location

  • 1555 Long Pond Road Department Of Medicine
  • Rochester, NY 14626-4122

Phone: (585) 723-7870

Specialties

  • Family Nurse Practitioner (363LF0000X)
Full Record
NPI
1548782204
Entity Type
Individual
Last Name
Dewilde
First Name
Lisa
Middle Name
Anne
Credential
FNP
Mailing Street Address
1555 Long Pond Road Department Of Medicine
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14626-4122
Mailing Country
US
Mailing Phone
(585) 723-7870
Mailing Fax
(585) 723-7871
Practice Street Address
1555 Long Pond Road Department Of Medicine
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14626-4122
Practice Country
US
Practice Phone
(585) 723-7870
Practice Fax
(585) 723-7871
Enumeration Date
July 13, 2017
Last Updated
March 01, 2018
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X)
Other Identifiers
04833414 (NY)