Jennifer Lynn Bollmann, LPN
Individual provider Active NPI Licensed Practical Nurse · Selden, NY
NPI 1104250299 · NPPES record last updated Aug 26, 2013
Key facts
- NPI
- 1104250299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 315534 (NY)
- Practice address
- 533 College Rd
Selden, NY 11784-2851 - Phone
- (571) 594-0956
- NPI assigned
- Aug 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 315534 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 315534 | NY | Yes |
Addresses
Primary practice location
533 College Rd
Selden, NY 11784-2851
Mailing address
75 Mayfield Dr
Mastic Beach, NY 11951-1726
Phone (571) 594-0956
Other providers in Selden, NY
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- Charles G Bleecher
- Jeannine Bockelmann
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- Henri Alexander Bonilla
- Kimberly Booker
- Pauline Angella Boothe
- Annemarie C Bradley
- Gail M Breslin
All providers in Selden, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.