JANE M PRENDERGAST


Address: 218 Stone St Fl 2, Community Clinic of Jefferson County, Watertown, NY 13601-3211
Phone: 3157827445

JANE M PRENDERGAST (NPI# 1346322450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346322450
Entity Type Individual
Full Name JANE M PRENDERGAST
Credential NP
Practice Address 218 Stone St Fl 2
Community Clinic of Jefferson County
Watertown
NY 13601-3211
Mailing Address 338 Frenchs Bay Rd
Tully
NY 13159-9440
Practice Telephone 3157827445
Practice Fax Number 3157791184
Mailing Telephone 3153176940
Enumeration Date 2006-10-19
Last Update Date 2011-07-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
303635 NY Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
F400868 NY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 218 STONE ST FL 2
COMMUNITY CLINIC OF JEFFERSON COUNTY
City WATERTOWN
State NY
Zip Code 13601-3211

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700162732 Rebecca M Sands Social Worker 218 Stone St Fl 2, Watertown, NY 13601-3211 2011-10-21
1972884591 Rosamond I Mcavoy Social Worker 218 Stone St Fl 2, Community Clinic of Jefferson County, Watertown, NY 13601-3211 2011-09-09
1376824912 Nicole L Pierce Social Worker 218 Stone St Fl 2, Community Clinic of Jefferson County, Watertown, NY 13601-3211 2011-09-08
1760770085 Kathy A Willenborg Registered Nurse 218 Stone St Fl 2, Community Clinic of Jefferson County, Watertown, NY 13601-3211 2011-07-20
1285922591 Sarah V Warner Art Therapist 218 Stone St Fl 2, Community Clinic of Jefferson County, Watertown, NY 13601-3211 2011-07-20
1710206008 Elizabeth A Parris Social Worker 218 Stone St Fl 2, Watertown, NY 13601-3211 2010-05-26
1073632485 Christina M Oneil Social Worker 218 Stone St Fl 2, Watertown, NY 13601-3211 2007-03-28

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1851855431 Hanna Kearney Physical Therapist 20053 Summit View Blvd Ste 2, Watertown, NY 13601 2019-01-28
1578039905 North Country Counseling Services LLC Counselor 210 Court St. Suite 4, Watertown, NY 13601 2018-10-24
1073004388 Megan Anna O'brien Counselor 221 S Rutland Street, Watertown, NY 13601 2018-05-22
1558860536 Kimberly Lynne Amelio Specialist 24850 Hinds Rd, Watertown, NY 13601 2018-02-06
1952840050 Alberto Gonzalez Social Worker 211 Jb Wise Plaza, Watertown, NY 13601 2017-02-22
1073967386 Amanda Pisarski Licensed Practical Nurse 26713 Nys Rte 12, Watertown, NY 13601 2016-04-22
1396137709 Daniel Ernest Morgan Neuromusculoskeletal Medicine & OMM 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 2015-02-21
1568868131 Megan E. Zamora Dental Hygienist 14652-b Cedar Way, Watertown, NY 13601 2014-11-10
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659920890 Zachary Ryan Lynch Nurse Practitioner 211 Jb Wise Place, Watertown, NY 13601-2507 2019-09-10
1891353587 Erin Lee Phinney Nurse Practitioner 482 Black River Parkway, Watertown, NY 13601-2413 2019-05-29
1831441344 Linda Macqueen Nurse Practitioner 211 J.b. Wise Plaza, Watertown, NY 13601 2012-10-08
1285827915 Jessica B Howell Nurse Practitioner 286 Arlington St, Watertown, MA 02472-3510 2007-08-27
1841304656 Carol Coy Nurse Practitioner 144 Eastern Blvd, Watertown, NY 13601-3132 2006-08-18
1982225256 Chika Francess Egorho Nurse Practitioner 211 J.b. Wise Plaza, Watertown, NY 13601 2020-04-28
1588215156 Rise Up Behavioral Health Services LLC Nurse Practitioner 76 Westbury Park Rd, Watertown, CT 06795-2779 2019-09-25
1417515552 Kourtney K Darrow Nurse Practitioner 211 J.b. Wise Plaza, Watertown, NY 13601 2019-06-04
1528534138 Martha Shirley Labarr Nurse Practitioner 830 Washington St, Watertown, NY 13601-4034 2018-10-22
1851743124 Brandy Baillargeon Nurse Practitioner 167 Polk St, Suite 300, Watertown, NY 13601-2097 2016-07-11
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Competitor

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City WATERTOWN
Zip Code 13601

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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