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NPI Code Detail

MEDICARE: MS. JENNIFER-JO WEBER LPN

MEDICARE:  MS. JENNIFER-JO  WEBER  LPN
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
1164W00000XLicensed Practical Nurse307916-1NY

General Provider Information

NPI Number : 1093072431
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER-JO WEBER LPN
Provider Business Mailing Address
First Line : 34 SOUTH RD
Second Line :
City : MOUNT MARION
State : NY
Zip : 12456-6017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 34 SOUTH RD
Second Line :
City : MOUNT MARION
State : NY
Zip : 12456-6017
Country : US
Telephone Number : 845-430-5041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2012
Last Update Date : 04/23/2012

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Directions to “ MS. JENNIFER-JO WEBER LPN” Practice Location

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