National Provider Identifier

Katrina Marie Phanthourath

Katrina Marie Phanthourath is listed in the NPPES registry with a primary specialty of Registered Nurse in Rochester, NY and a listed phone number of (585) 530-7626.

NPI 1629804661Rochester, NYRegistered Nurse

Profile Overview

NPI
1629804661
Provider Type
Individual
Primary Specialty
Registered Nurse
Enumeration Date
September 09, 2024
Last Updated
September 09, 2024

Practice Location

  • 48 Gawaine Ln
  • Rochester, NY 14623-5536

Phone: (585) 530-7626

Specialties

  • Registered Nurse (163W00000X)
Full Record
NPI
1629804661
Entity Type
Individual
Last Name
Phanthourath
First Name
Katrina
Middle Name
Marie
Mailing Street Address
48 Gawaine Ln
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14623-5536
Mailing Country
US
Practice Street Address
48 Gawaine Ln
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14623-5536
Practice Country
US
Practice Phone
(585) 530-7626
Enumeration Date
September 09, 2024
Last Updated
September 09, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
September 09, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Registered Nurse (163W00000X)