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General NPI Number Information
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NPI Number | 1982926440
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Entity Type | Individual
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Provider Name | JEANNE A ELISHA FNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2010
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 45 FERRY STREET TROY NY RUSSELL SAGE COLLEGE
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City | TROY
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State | NY
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Zip | 12180
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Country | US
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Telephone | 518-244-2261
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Fax | 518-244-2262
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Provider Business Mailing Address
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Address Line | 45 FERRY STREET RUSSELL SAGE COLLEGE ATTENTION WELLNESS CENTER
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City | TROY
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State | NY
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Zip | 12180
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Country | US
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Telephone | 518-244-2261
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Fax | 518-244-2262
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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 | 331488
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License Number State | NY
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