Provider Demographics
NPI:1598545683
Name:CARMODY, JANE (DNP MBA, RN, FAAN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:CARMODY
Suffix:
Gender:F
Credentials:DNP MBA, RN, FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E 59TH ST FL 16
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1713
Mailing Address - Country:US
Mailing Address - Phone:402-880-5620
Mailing Address - Fax:
Practice Address - Street 1:55 E 59TH ST FL 16
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1713
Practice Address - Country:US
Practice Address - Phone:402-880-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY728963-01163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology