Provider Demographics
NPI:1407898356
Name:ALBERRY, JENIFFER DAWN (FNP)
Entity Type:Individual
Prefix:
First Name:JENIFFER
Middle Name:DAWN
Last Name:ALBERRY
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 1:4 FULLER STREET
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA BAY
Mailing Address - State:NY
Mailing Address - Zip Code:13607
Mailing Address - Country:US
Mailing Address - Phone:315-482-2094
Mailing Address - Fax:315-482-3727
Practice Address - Street 1:4 FULLER STREET
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA BAY
Practice Address - State:NY
Practice Address - Zip Code:13607
Practice Address - Country:US
Practice Address - Phone:315-482-2094
Practice Address - Fax:315-482-3727
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily