Jodi Anne Brundige, LPN

Individual provider Active NPI Licensed Practical Nurse · Johnsonville, NY

NPI 1194918342 · NPPES record last updated Oct 20, 2020

Key facts

NPI
1194918342
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
267328 (NY)
Practice address
84 Quaker Rd
Johnsonville, NY 12094-3022
Phone
(518) 705-9811
NPI assigned
Aug 21, 2007
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

LicenseStateTypeSpecialty
267328NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 267328 NY Yes

Addresses

Primary practice location

84 Quaker Rd
Johnsonville, NY 12094-3022

Mailing address

7 John St Apt 1
Hoosick Falls, NY 12090-1633
Phone (838) 839-1344

Other names

  • Jodi Anne Schultz Former name

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL 84Quaker Direct

Other providers in Johnsonville, NY

All providers in Johnsonville, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.