Doctor Name: | CAROLYN VAVRECAN |
NPI Number: | 1174953947 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | F338227 |
Business Practice Address: | 127 N Main St Wellsville, NY - 148951149 |
Business Phone Number: | 5855962040 |
Business Fax Number: | |
Mailing Address: | 127 N Main St, WELLSVILLE |
State: | NY |
Postal Code: | 148951149 |
Phone Number: | 5855962040 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2013 |
NPI Last Update Date: | 11/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F338227 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |