Provider Demographics
NPI:1912018938
Name:TIMM, JENNIFER M (RN, NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:TIMM
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:70 MORIN CIR
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 675
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-7753
Practice Address - Fax:585-461-0662
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY333501363LF0000X
NY477610-0163W00000X
NYF333501-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered163W00000XNursing Service ProvidersRegistered Nurse