Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | F001035-1 | NY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 401474 | NY |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 360524 | NY |
NPI | 1053471755 |
---|---|
Provider Name | Jaime K Nass |
First Address | Albany, NY 12206-2213 |
Second Address | Albany, NY 12206-2213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 24/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11243785 | CAQH (01) | NY |