MEDICARE: MS. ALISON C JENNINGS AGPCNP-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	163WI0500X	Infusion Therapy Registered Nurse	524597	NY
2	363LA2200X	Adult Health Nurse Practitioner	307761	NY
3	363L00000X	Nurse Practitioner	LP-0010533	DE

General Provider Information

NPI Number	:	1659733665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALISON C JENNINGS AGPCNP-BC

Provider Business Mailing Address
First Line	:	244 5TH AVE
Second Line	:	SUITE J253
City	:	NEW YORK
State	:	NY
Zip	:	10001-7604
Country	:	US
Telephone Number	:	631-213-1717
Fax Number	:

Provider Business Practice Location Address
First Line	:	623 W NEWPORT PIKE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19804-3235
Country	:	US
Telephone Number	:	302-777-5473
Fax Number	:

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

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	10/16/2024

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