Individual
MARY THERESA JAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 WASHINGTON ST, ELMIRA, NY 14901-2849
(607) 737-4927
Mailing address
100 WASHINGTON ST, ELMIRA, NY 14901-2849
(607) 737-4927
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
490805
NY
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
490805
NY
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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