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General NPI Number Information
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NPI Number | 1518422567
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Entity Type | Individual
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Provider Name | CHRIS ANNE JEWETT NP
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Gender | Female
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 826 WASHINGTON ST STE 106
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City | WATERTOWN
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State | NY
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Zip | 13601-4071
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Country | US
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Telephone | 315-755-3083
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Fax |
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Provider Business Mailing Address
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Address Line | 711 STATE HIGHWAY 37
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City | HAMMOND
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State | NY
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Zip | 13646-3282
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Country | US
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Telephone | 315-523-4553
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F3439481
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License Number State | NY
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