Provider Demographics
NPI:1407105562
Name:LAFFERTY, JENNIFER ANNE (RN)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:ANNE
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 RED JACKET PKWY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2010
Mailing Address - Country:US
Mailing Address - Phone:716-381-1445
Mailing Address - Fax:
Practice Address - Street 1:43 RED JACKET PKWY
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2010
Practice Address - Country:US
Practice Address - Phone:716-381-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY634254-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse