Basic Information
| Provider Information | |||||||||
| NPI: | 1962010272 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARKINS | ||||||||
| FirstName: | JANNET | ||||||||
| MiddleName: | LI | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | FNP, PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | UBMD PSYCHIATRY/UPP | ||||||||
| Address2: | 462 GRIDER STREET ROOM 1168 | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168984968 | ||||||||
| FaxNumber: | 7168984447 | ||||||||
| Practice Location | |||||||||
| Address1: | 462 GRIDER ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142153021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168985759 | ||||||||
| FaxNumber: | 7169617783 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2020 | ||||||||
| LastUpdateDate: | 09/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 709741 | NY | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 345604 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | 402925 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.