Healthcare Provider Details

I. General information

NPI: 1346475613
Provider Name (Legal Business Name): JOANNE E SPEICHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22-24 EAST MAIN STREET
MARATHON NY
13803-0448
US

IV. Provider business mailing address

2359 SESSIONS HILL RD
HOMER NY
13077-9462
US

V. Phone/Fax

Practice location:
  • Phone: 607-849-3271
  • Fax: 607-849-6357
Mailing address:
  • Phone: 607-753-9946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number607074
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: