MEDICARE: JAMIE J MARTIN RN

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	163WS0200X	School Registered Nurse	810245	NY

General Provider Information

NPI Number	:	1518770791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE J MARTIN RN

Provider Business Mailing Address
First Line	:	37 WEATHERWOOD LN
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-3739
Country	:	US
Telephone Number	:	315-226-0911
Fax Number	:

Provider Business Practice Location Address
First Line	:	37 WEATHERWOOD LN
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-3739
Country	:	US
Telephone Number	:	315-226-0911
Fax Number	:

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

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	01/30/2025

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