Provider Demographics
NPI:1053708149
Name:TOMENO, KAITLYN (RN)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:TOMENO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:DEEGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:46 LILAC DR APT 6
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3270
Mailing Address - Country:US
Mailing Address - Phone:585-880-7356
Mailing Address - Fax:
Practice Address - Street 1:46 LILAC DR APT 6
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3270
Practice Address - Country:US
Practice Address - Phone:585-880-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672317163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse