Provider Demographics
NPI:1235202698
Name:FIERO, JAYNE LORA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:LORA
Last Name:FIERO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 LAKE OSIRIS RD
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2620
Mailing Address - Country:US
Mailing Address - Phone:845-778-7683
Mailing Address - Fax:845-778-7683
Practice Address - Street 1:53 GIBSON RD
Practice Address - Street 2:ORANGE-ULSTER BOCES, SPECIAL EDUCATION
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6709
Practice Address - Country:US
Practice Address - Phone:845-291-0200
Practice Address - Fax:845-778-7683
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291276-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily