Individual provider · NPI-1

Michelle Katherine Addison

Nurse Practitioner, Family · Rochester, NY

NPI number1043820251
StatusActive
Last updated in NPPESAug 23, 2022

Details

NPI
1043820251
Entity type
Individual (NPI-1)
Name
Michelle Katherine Addison
Sex
Female
Sole proprietor
No
Enumeration date
Aug 3, 2020
Certification date
Aug 23, 2022
Last updated
Aug 23, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family346255NYYes

Other names

  • Michelle Katherine Hiczun (Former Name)

Practice location

20 Hagen Dr Ste 330
Rochester, NY 14625-2664

Phone 585-267-4040

Mailing address

109 Armstrong Ave
Rochester, NY 14617-4603

Phone 716-957-8537

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