Provider Demographics
NPI:1528337698
Name:JORGENSEN, ANNE MARIE (RN, MS, NNP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:JORGENSEN
Suffix:
Gender:F
Credentials:RN, MS, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 ROCHELLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5853
Mailing Address - Country:US
Mailing Address - Phone:845-553-5657
Mailing Address - Fax:
Practice Address - Street 1:32 ROCHELLE DR
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5853
Practice Address - Country:US
Practice Address - Phone:845-553-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350111-1363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care