Provider Demographics
NPI:1881041804
Name:CODY, JOCELYN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:
Last Name:CODY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:FERLAND
Other - Last Name:THERIAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:448 TEMPLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5510
Mailing Address - Country:US
Mailing Address - Phone:845-562-2191
Mailing Address - Fax:
Practice Address - Street 1:448 TEMPLE HILL RD
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553
Practice Address - Country:US
Practice Address - Phone:845-562-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20834363LF0000X
NY342982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily