Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER DAWN CONDLIN, RN
Deactivated Sole ProprietorJENNIFER DAWN CONDLIN, RN is a Family Nurse Practitioner healthcare provider located in PORTJEFFERSON, New York. NPI 1720360340 is deactivated in the NPPES registry. Verify at CMS.
Family Nurse Practitioner · PORTJEFFERSON, NY
This NPI has been deactivated.
The record was deactivated on November 24, 2020.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1720360340
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 10, 2011 (9.2054794520548 yrs)
- Last Updated
- May 5, 2021
- Deactivated
- Nov 24, 2020
- Licenses
-
636754-1 (NY)F346007-01 (NY)346007 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
75 NORTH COUNTRY ROADPORTJEFFERSON, NY, 11777Browse NY providers · Browse ZIP 11777
- Phone
- 6314731320
- Primary Specialty
-
Family Nurse Practitioner
363LF0000X
- Additional Specialty
- Family Nurse Practitioner
- Additional Specialty
- Family Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.