Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jean-Ann McKiernan, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1093675803

Jean-Ann McKiernan, NURSEPRACTITIONER is a Nurse Practitioner in Staten Island, New York. Qualified in 2020, 6 years ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2025
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Practice location Address checks out

82 Waldron Ave Fl 1
Staten Island, NY 10301-3656
Phone: (347) 277-2136
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 691690 (NY)

Record details

NPI number1093675803
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedNovember 13, 2025
Last updated in NPPESNovember 13, 2025
Certification dateNovember 13, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Staten Island