Provider Demographics
NPI:1891460150
Name:ANTHONY, JENNIFER PASLEY (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PASLEY
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LATTIMORE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4155
Mailing Address - Country:US
Mailing Address - Phone:585-273-3608
Mailing Address - Fax:
Practice Address - Street 1:125 LATTIMORE RD STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4155
Practice Address - Country:US
Practice Address - Phone:585-273-3608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403581207R00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine