Provider Demographics
NPI:1033079751
Name:KOSS, JENNA (FNP)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:KOSS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 DANBURY CIR S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2754
Mailing Address - Country:US
Mailing Address - Phone:585-746-0451
Mailing Address - Fax:
Practice Address - Street 1:500 RED CREEK DR STE 120
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4284
Practice Address - Country:US
Practice Address - Phone:585-746-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3365085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily