=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356519979
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA L HAND RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2008
-----------------------------------------------------
Last Update Date | 01/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5950 HUBBARD RD
-----------------------------------------------------
City | ADDISON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14801-9439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-426-6903
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 64 SOUTH ST
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14813-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-426-6903
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 796106
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------