Doctor Name: | MS. JENNY ELLEN ROSS |
NPI Number: | 1538443114 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | F336997 |
Business Practice Address: | 23 Central St Moravia, NY - 131183427 |
Business Phone Number: | 3154979066 |
Business Fax Number: | 3154973836 |
Mailing Address: | 17 Main St, Suite 302 CORTLAND |
State: | NY |
Postal Code: | 130456606 |
Phone Number: | 6077533797 |
Fax Number: | 6077536677 |
NPI Enumeration Date: | 09/30/2011 |
NPI Last Update Date: | 02/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SF0001X |
License Number: | F336997 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Family Health |
Taxonomy Definition: |