National Provider Identifier

Kimberly Jo Tuttle, PA

Kimberly Jo Tuttle, PA is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Canandaigua, NY and a listed phone number of (585) 393-3515.

NPI 1558560995Canandaigua, NYMedical Physician Assistant

Profile Overview

NPI
1558560995
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
July 16, 2007
Last Updated
July 28, 2016

Practice Location

  • 495 N Main St
  • Canandaigua, NY 14424-1283

Phone: (585) 393-3515

Specialties

  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1558560995
Entity Type
Individual
Last Name
Tuttle
First Name
Kimberly
Middle Name
Jo
Credential
PA
Provider Other Last Name
Willis
Provider Other First Name
Kimberly
Provider Other Middle Name
Jo
Provider Other Last Name Type Code
1
Mailing Street Address
495 N Main St
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-1283
Mailing Country
US
Mailing Phone
(585) 393-3515
Practice Street Address
495 N Main St
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-1283
Practice Country
US
Practice Phone
(585) 393-3515
Practice Fax
(585) 393-3515
Enumeration Date
July 16, 2007
Last Updated
July 28, 2016
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X)
Other Identifiers
03385908 (NY)