Individual
JENNY AMANDA BARNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5232 WITZ DR, NORTH SYRACUSE, NY 13212
(888) 562-5442
Mailing address
11 SOUTHERN HILLS CIR, HENRIETTA, NY 14467-9709
(585) 520-8911
(585) 548-0107
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
305388
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F305388
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F305388
LICENSE
—
Enumeration date
08/24/2010
Last updated
08/09/2021
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