Provider Demographics
NPI:1740535558
Name:KAPILLA, JAMIE N (RN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:N
Last Name:KAPILLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 BRONSON RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-2203
Mailing Address - Country:US
Mailing Address - Phone:315-481-7947
Mailing Address - Fax:
Practice Address - Street 1:413 BRONSON RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13219-2203
Practice Address - Country:US
Practice Address - Phone:315-481-7947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605039-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse