Provider Demographics
NPI:1962010272
Name:HARKINS, JANNET LI (FNP, PMHNP)
Entity Type:Individual
Prefix:MISS
First Name:JANNET
Middle Name:LI
Last Name:HARKINS
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UBMD PSYCHIATRY/UPP
Mailing Address - Street 2:462 GRIDER STREET ROOM 1168
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-4968
Mailing Address - Fax:716-898-4447
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5759
Practice Address - Fax:716-961-7783
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY709741163W00000X
NY345604363LF0000X
NY402925363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily