Provider Demographics
NPI:1588176531
Name:DUFRANE, JODI LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:DUFRANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LYNN
Other - Last Name:JORDAL, SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2607
Mailing Address - Country:US
Mailing Address - Phone:315-532-8941
Mailing Address - Fax:
Practice Address - Street 1:138 E 3RD ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2607
Practice Address - Country:US
Practice Address - Phone:315-532-8941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542722-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse