Provider Demographics
NPI:1043574163
Name:RINK, JESSIE BLAIR (NP)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:BLAIR
Last Name:RINK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PRATHER AVE
Mailing Address - Street 2:SUITE NUMBER 1
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-6820
Mailing Address - Country:US
Mailing Address - Phone:716-488-1200
Mailing Address - Fax:
Practice Address - Street 1:320 PRATHER AVE
Practice Address - Street 2:SUITE NUMBER 1
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-6820
Practice Address - Country:US
Practice Address - Phone:716-488-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily