Doctor Name: | JEMMA LEE BAILEY-KUNTE |
NPI Number: | 1104892736 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, FNPC |
License Number: | F330014 |
Business Practice Address: | 130 Temple St Suite 100 Owego, NY - 138271421 |
Business Phone Number: | 6076875616 |
Business Fax Number: | 6076875989 |
Mailing Address: | 835 Pennsylvania Ave, APALACHIN |
State: | NY |
Postal Code: | 137322509 |
Phone Number: | 6076875615 |
Fax Number: | 6076875989 |
NPI Enumeration Date: | 02/24/2006 |
NPI Last Update Date: | 07/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F330014 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |