Provider Demographics
NPI:1962146829
Name:BELLINGTON, JENIFFER R
Entity type:Individual
Prefix:
First Name:JENIFFER
Middle Name:R
Last Name:BELLINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SAINT PAUL ST APT 301
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-1703
Mailing Address - Country:US
Mailing Address - Phone:419-581-0750
Mailing Address - Fax:
Practice Address - Street 1:360 SAINT PAUL ST APT 301
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-1703
Practice Address - Country:US
Practice Address - Phone:419-581-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339420164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse