Individual
JENNIFER HALEY VOSBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
711 TROY SCHENECTADY RD, SUITE 101, LATHAM, NY 12110-2442
(518) 783-3110
(518) 783-7506
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
577026
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382302
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03474664
—
NY
01
—
120827000152
FIDELIS CARE NY
NY
Enumeration date
05/24/2012
Last updated
05/19/2014
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