Provider Demographics
NPI:1295353266
Name:JODIE DEIGNAN NURSE PRACTITIONER IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:JODIE DEIGNAN NURSE PRACTITIONER IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEIGNAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:914-216-7550
Mailing Address - Street 1:55 MCKINLEY AVE APT DG-8
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1659
Mailing Address - Country:US
Mailing Address - Phone:508-317-2486
Mailing Address - Fax:
Practice Address - Street 1:50 MAIN ST STE 1000
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1900
Practice Address - Country:US
Practice Address - Phone:914-217-7550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty