Jennifer Eisenhauer

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

336008 Issued in NY

Practice address

22 Maier Cir
Spencerport, NY 14559-2419

Phone

(585) 749-8075

NPI assigned

Oct 14, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Eisenhauer Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1912549601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MAIER CIR",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MAIER CIR",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592419",
            "telephone_number": "585-749-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHAUER",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "336008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336008",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "home",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22 Maier Cir",
            "city": "Spencerport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145592419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "EISENHAUER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taryn Duval, LPN
• Sharese Dyson, LPN
• Hilary Dzina, MS,OT
• June Ebersold
• Krystal June Eichas, M.S., CCC-SLP, NYS-L
• Heather J Elias, OTR
• Amanda Jean Entress, MS OTR/L
• Traci-Lynn Marie Farley, M.S., CCC-A
• Ryan Paul Favata, LPN
• Heather L Fellows

• Licensed Practical Nurse in Spencerport, NY
• Providers in Spencerport, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.