Individual
JENNA M MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1200 DRIVING PARK AVE, NEWARK, NY 14513
(315) 359-2847
(315) 359-2806
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN692886
PA
363L00000X
Nurse Practitioner
Primary
341400
NY
363L00000X
Nurse Practitioner
SP017917
PA
Other
Enumeration date
07/31/2017
Last updated
02/12/2019
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