Provider Demographics
NPI:1952187361
Name:HETHERINGTON, JEANETTE FRANCES (RN)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:FRANCES
Last Name:HETHERINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:FRANCES
Other - Last Name:HAGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4 SCANDELL CT
Mailing Address - Street 2:
Mailing Address - City:TOMKINS COVE
Mailing Address - State:NY
Mailing Address - Zip Code:10986-1406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 SCANDELL CT
Practice Address - Street 2:
Practice Address - City:TOMKINS COVE
Practice Address - State:NY
Practice Address - Zip Code:10986-1406
Practice Address - Country:US
Practice Address - Phone:203-907-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685722163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool