Henderson, Jennifer Joy

Henderson, Jennifer Joy is an sole proprietor health care provider with primary practice located at 1 Grove St , Waterloo NY 13165-1709. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Henderson, Jennifer Joy can be contacted via phone (315) 651-0272.

Contact Information

Primary practice address
1 Grove St Waterloo NY 13165-1709
Phone: (315) 651-0272
Fax: (315) 539-3285
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 698139 New York

Profile Details

NPI number 1528489556
LBN Legal business name Henderson, Jennifer Joy
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 17th, 2013
Last updated Oct 1st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528489556 NPPES
New York MEDICAID 1528489556

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