Healthcare Provider Details

I. General information

NPI: 1386454197
Provider Name (Legal Business Name): EMMA JANE VAN NESS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 TEMPLE HILL RD STE 102
NEW WINDSOR NY
12553-5529
US

IV. Provider business mailing address

484 TEMPLE HILL RD STE 102
NEW WINDSOR NY
12553-5529
US

V. Phone/Fax

Practice location:
  • Phone: 845-565-3700
  • Fax: 845-565-3395
Mailing address:
  • Phone: 845-565-3700
  • Fax: 845-565-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number355858
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: