Healthcare Provider Details

I. General information

NPI: 1699255711
Provider Name (Legal Business Name): JASMINE HEGDE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1967 WEHRLE DR STE 1086
BUFFALO NY
14221-8452
US

IV. Provider business mailing address

305 E 86TH ST
NEW YORK NY
10028-4702
US

V. Phone/Fax

Practice location:
  • Phone: 419-973-5585
  • Fax:
Mailing address:
  • Phone: 212-722-2003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344120-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022814
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN337856
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: