Basic Information
Provider Information
NPI: 1992328306
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEESE
FirstName: CHRISTY
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 KINGS HWY S
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146175504
CountryCode: US
TelephoneNumber: 5859224200
FaxNumber: 5859224922
Practice Location
Address1: 1415 PORTLAND AVE STE 400
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146213022
CountryCode: US
TelephoneNumber: 5859224200
FaxNumber: 5859224922
Other Information
ProviderEnumerationDate: 05/20/2020
LastUpdateDate: 02/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X002015NYY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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