Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | F380384-1 | NY |
Y | 363L00000X | Nurse Practitioner | 380384 | NY |
N | 363LP0200X | Nurse Practitioner - Pediatrics | F380384-1 | NY |
NPI | 1033388822 |
---|---|
Provider Name | Nancy A. Jones |
First Address | Syracuse, NY 13202-2240 |
Second Address | Syracuse, NY 13202-2240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2008 |
Last Update Date | 30/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02957651 | (05) | NY |