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Individual

MS. JENNA HAYDEN CARROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
901 WAYNE ST, OLEAN, NY 14760-2255
(716) 257-1254
(716) 215-6170
Mailing address
901 WAYNE ST, OLEAN, NY 14760-2255
(716) 257-1254
(716) 215-6170

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
774542
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F-403943-01
NY

Other

Enumeration date
12/01/2021
Last updated
06/19/2024
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