Individual
JANE O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
219 BRYANT ST, BUFFALO, NY 14222-2006
(716) 878-7561
(716) 888-3801
Mailing address
4511 HARLEM RD, SUITE 202, AMHERST, NY 14226-3803
(716) 839-6720
(716) 839-6740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
253734
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F380436
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026525401
UNIVERA
—
01
—
000560727001
BC/BS
—
05
—
02313808
—
NY
01
—
040426002947
FIDELIS
—
01
—
9511762
IHA
—
Enumeration date
10/21/2006
Last updated
09/30/2008
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