Healthcare Provider Details

I. General information

NPI: 1518770791
Provider Name (Legal Business Name): JAMIE J MARTIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE JO REHBERG RN

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 09/29/2026
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 WEATHERWOOD LN
ROCHESTER NY
14624-3739
US

IV. Provider business mailing address

37 WEATHERWOOD LN
ROCHESTER NY
14624-3739
US

V. Phone/Fax

Practice location:
  • Phone: 315-226-0911
  • Fax:
Mailing address:
  • Phone: 315-226-0911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number810245
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: