Provider Demographics
NPI:1255341087
Name:ROE, EMILY HANNA (FNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:HANNA
Last Name:ROE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:HANNA
Other - Last Name:CORIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-3131
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-273-3131
Practice Address - Fax:585-756-7786
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3349211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02866851Medicaid
NY02866851Medicaid
NYRB2575Medicare PIN
NYQ77465Medicare UPIN