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NPI Code Detail

MEDICARE: MS. PATRICIA ANNE JUERGENS NURSE PRACTITIONER

MEDICARE: MS. PATRICIA ANNE JUERGENS NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF332779-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P0140059HLOTHERNYBCHOICE (OP) PHYS GRP
21158OTHERNYBCROSS PHYSICANS GRP
3G0180227590OTHERNYBCHOICE PHYSCIAN GRP

General Provider Information

NPI Number : 1073625455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA ANNE JUERGENS NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 50 AYRSHIRE LN
Second Line :
City : HENRIETTA
State : NY
Zip : 14467-9379
Country : US
Telephone Number : 585-737-0578
Fax Number :
Provider Business Practice Location Address
First Line : 500 HAHNEMANN TRL
Second Line :
City : PITTSFORD
State : NY
Zip : 14534-2356
Country : US
Telephone Number : 585-383-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/09/2007

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