Provider Demographics
NPI:1609371665
Name:STREIFF, JACQUELINE ANN (RN)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:ANN
Last Name:STREIFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 STATE FAIR BLVD APT 123
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13209-1218
Mailing Address - Country:US
Mailing Address - Phone:315-391-4686
Mailing Address - Fax:
Practice Address - Street 1:29 E ONEIDA ST
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-2400
Practice Address - Country:US
Practice Address - Phone:315-638-6043
Practice Address - Fax:316-638-6041
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351944163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool