Healthcare Provider Details

I. General information

NPI: 1821107517
Provider Name (Legal Business Name): WENDY JENSEN HILL MSNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 PRE EMPTION RD
PENN YAN NY
14527-9641
US

IV. Provider business mailing address

1930 PRE EMPTION RD
PENN YAN NY
14527-9549
US

V. Phone/Fax

Practice location:
  • Phone: 315-536-7725
  • Fax: 315-536-4107
Mailing address:
  • Phone: 315-536-0008
  • Fax: 315-536-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF301653-A
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: