Healthcare Provider Details

I. General information

NPI: 1114526860
Provider Name (Legal Business Name): JENNIFFER L TUTTLE PHD, RN, CHPN, CNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 VESTAL PKWY E
BINGHAMTON NY
13902-4400
US

IV. Provider business mailing address

3675 PINE HILL RD
CORNING NY
14830-9742
US

V. Phone/Fax

Practice location:
  • Phone: 607-777-4954
  • Fax:
Mailing address:
  • Phone: 585-787-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number588811
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: