Provider Demographics
NPI:1437924990
Name:THOMPSON-EDWARDS, JENNIFER L (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:THOMPSON-EDWARDS
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 1:1065 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-5701
Mailing Address - Country:US
Mailing Address - Phone:518-370-8295
Mailing Address - Fax:
Practice Address - Street 1:1065 BAKER AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-5701
Practice Address - Country:US
Practice Address - Phone:518-370-8295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY514145163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool