Jungquist, Carla R

Jungquist, Carla R is an individual health care provider with primary practice located at 3170 West St Ste 275 , Canandaigua NY 14424-1711. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Jungquist, Carla R can be contacted via phone (585) 341-7575.

Contact Information

Primary practice address
3170 West St Ste 275 Canandaigua NY 14424-1711
Phone: (585) 341-7575
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 331694 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 339960 New York

Profile Details

NPI number 1245268747
LBN Legal business name Jungquist, Carla R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Jun 11th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245268747 NPPES
New York MEDICAID 02379573

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