=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699308759
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER M CAGE RN, FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2020
-----------------------------------------------------
Last Update Date | 10/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6950 WILLIAMS RD
-----------------------------------------------------
City | NIAGARA FALLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14304-3025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-671-5083
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 604 GLENN DR
-----------------------------------------------------
City | NEW BERN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28562-7836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-671-5083
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 345519
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------