Provider Demographics
NPI:1689927790
Name:CAPELLAN, JAHAIRA CAROLINA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JAHAIRA
Middle Name:CAROLINA
Last Name:CAPELLAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 PARSELLS AVENUE
Mailing Address - Street 2:THRESHOLD CENTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609
Mailing Address - Country:US
Mailing Address - Phone:585-454-7530
Mailing Address - Fax:585-454-7138
Practice Address - Street 1:145 PARSELLS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-5118
Practice Address - Country:US
Practice Address - Phone:585-454-7539
Practice Address - Fax:585-454-7138
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily