Healthcare Provider Details

I. General information

NPI: 1992975569
Provider Name (Legal Business Name): JENNIFER FESINMEYER MS, NNP-BC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST BOX #356077
SEATTLE WA
98195-6077
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX #356077
SEATTLE WA
98195-6077
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4606
  • Fax:
Mailing address:
  • Phone: 206-598-4606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP3055
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number60264769
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN113825
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number60264767
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: