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General NPI Number Information
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NPI Number | 1124247713
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Entity Type | Individual
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Provider Name | JANE RUTH MONNELL APRN BC FNP
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 421 MONTGOMERY ST 9TH FLOOR
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City | SYRACUSE
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State | NY
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Zip | 13202
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Country | US
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Telephone | 315-435-3295
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Fax |
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Provider Business Mailing Address
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Address Line | 9 MEADOW LANE
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City | CAMILLUS
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State | NY
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Zip | 13031-1116
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Country | US
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Telephone | 315-672-9641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F331899-1
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License Number State | NY
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