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General NPI Number Information
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NPI Number | 1487103024
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Entity Type | Individual
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Provider Name | JAIME LYNN FERNANDEZ NP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 160 ROBINSON ST
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City | BINGHAMTON
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State | NY
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Zip | 13904-1842
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Country | US
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Telephone | 607-296-2300
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Fax | 607-296-2287
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Provider Business Mailing Address
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Address Line | 33 LEWIS RD FL 2
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City | BINGHAMTON
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State | NY
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Zip | 13905
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Country | US
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Telephone | 607-770-0025
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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 | SP022532
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340943
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License Number State | NY
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