MEDICARE: JENNIFER G RUBINO DNP, FNP-BC

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
1	163WC1500X	Community Health Registered Nurse	2268455	MA

General Provider Information

NPI Number	:	1134853526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER G RUBINO DNP, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 42
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-0042
Country	:	US
Telephone Number	:	413-717-7002
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 LEWIS AVE
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1886
Country	:	US
Telephone Number	:	413-528-1470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/29/2022

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