Jennifer Mastin, RN
Individual provider Active NPI Registered Nurse · Walworth, NY
NPI 1114348455 · NPPES record last updated Nov 6, 2023
Key facts
- NPI
- 1114348455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 55341-1 (NY)
- Practice address
- 3757 Orchard St
Walworth, NY 14568-9336 - Phone
- (585) 278-8136
- NPI assigned
- Jan 3, 2014
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55341-1 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 55341-1 | NY | Yes |
Addresses
Primary practice location
3757 Orchard St
Walworth, NY 14568-9336
Mailing address
3757 Orchard St
Walworth, NY 14568-9336
Phone (585) 278-8136
Other providers in Walworth, NY
- Emily R Knight
- Christina Lawrence
- Tanya Leigh Lent
- Sherralyn Longyear
- Aaron Mack
- Marcey J Merkley
- Brianna Marie Montes
- Marissa Nicholson
- Omar Osmen
- Babara Jo Philbrick
All providers in Walworth, NY · Registered 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 Nov 6, 2023. 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.