National Provider Identifier
Chittadaphone Phouthavong, RN
Chittadaphone Phouthavong, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Rochester, NY and a listed phone number of (585) 353-9305.
Profile Overview
- NPI
- 1952600330
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- March 24, 2011
- Last Updated
- August 19, 2019
Practice Location
- 111 Westfall RD
- Rochester, NY 14620-4647
Phone: (585) 353-9305
Specialties
- Registered Nurse (163W00000X)
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1952600330
- Entity Type
- Individual
- Last Name
- Phouthavong
- First Name
- Chittadaphone
- Credential
- RN
- Mailing Street Address
- 111 Westfall RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-4647
- Mailing Country
- US
- Mailing Phone
- (585) 353-9305
- Practice Street Address
- 111 Westfall RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-4647
- Practice Country
- US
- Practice Phone
- (585) 353-9305
- Enumeration Date
- March 24, 2011
- Last Updated
- August 19, 2019
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomies
- Registered Nurse (163W00000X), Licensed Practical Nurse (164W00000X)
- Other Identifiers
- 1952600330 (NY)