Keisha Nadine Antoine-Jennings, RN

Individual provider Active NPI Registered Nurse · Mount Vernon, NY

NPI 1992140354 · NPPES record last updated Apr 30, 2013

Key facts

NPI
1992140354
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
641502-1 (NY)
Practice address
76 Esplanade
Mount Vernon, NY 10553-1112
Phone
(347) 495-9987
NPI assigned
Apr 30, 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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
641502-1NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 641502-1 NY Yes

Addresses

Primary practice location

76 Esplanade
Mount Vernon, NY 10553-1112

Mailing address

76 Esplanade
Mount Vernon, NY 10553-1112
Phone (347) 495-9987

Other providers in Mount Vernon, NY

All providers in Mount Vernon, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.